Drainage
Conditions
Keywords
Tubeless, Wedge resection, Improved drainage strategy
Brief summary
This study evaluates the viability and safety of two-lumen catheterization versus complete omission of chest tube in patients with lung wedge resection. Half of participants will receive complete omission of chest tube, while the other half will receive a two-lumen central venous catheterization along the midclavicular line, second intercostal space for remedial gas-remove.
Detailed description
With the development of video-assisted thoracoscopic surgery (VATS) techniques, minimally invasive thoracic surgery has evolved considerably over the last three decades. The concept of tubeless involves non-intubated anesthesia with spontaneous ventilation and no chest tube placement. Chest tube placement always causes pain, and its duration is known to be one of the most important factors influencing hospital stay and costs. Early tube removal allows patients to breathe deeply with less pain, which leads to more compliance with chest physiotherapy, as demonstrated by a concomitant improvement in patients' ventilatory function. Hence, more and more experienced surgeons choose the omission of chest tube placement after lung wedge resection. However, based on previous retrospective studies, residual pneumothorax was noted in about 10% cases, and some of them need re-intervention. Hence, the investigators designed a intra-operative two-lumen catheterization as improved drainage strategy. Therefore, this study evaluates the viability and safety of two-lumen catheterization versus omission of chest tube placement in patients with lung wedge resection.
Interventions
PROCEDUREComplete omission of chest tube
No chest tube implacement
PROCEDUREImproved drainage strategy
A two-lumen central venous catheterization along the midclavicular line, second intercostal space for remedial gas-remove
Sponsors
Guangdong Provincial People's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Preoperative radiology revealed solitary peripheral pulmonary nodule, with both size and depth less than 3 cm 2. Lung wedge resection for tumor biopsy to elucidate drug resistant mechanism or confirm diagnosis
Exclusion criteria
1. Previous ipsilateral thoracic surgery or extensive adhesion 2. Preoperative radiology revealed pneumonia or atelectasis 3. Any unstable systemic disease (including active infection, uncontrolled hypertension, unstable angina, congestive heart failure, myocardial infarction within the previous year, serious cardiac arrhythmia requiring medication, hepatic, renal, or metabolic disease). 4. Bleeding tendency or anticoagulant use 5. Pregnancy or breast feeding 6. Patient who can not sign permit
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence rate of massive pneumothorax on day 1 after surgery | 1 day | To evaluate the incidence rate of pneumothorax (a pneumothorax greater than 2.0 cm on X-ray) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain score on day 1 after surgery | 1 day | To evaluate the pain score via numerical rating scale on day 1 after surgery. An 11-point numeric scale (NRS 11) with 0 representing no pain and 10 representing worst pain imaginable. |
| Length of post-operative hospital stay | 1 week | To evaluate the length of post-operative hospital stay. |
| Postoperative pulmonary function recovery | 1 month | To evaluate the postoperative cardiopulmonary function recovery via 6-minute walk test in both groups. |
Contacts
Primary ContactJia-Tao Zhang, Ph.D
Backup ContactWen-Zhao Zhong, Ph.D
Outcome results
None listed