Prospective rAndomized sTudy efficaCy tHree-dimensional rEconstructions Segmentectomy
- Conditions
- Lung; NodeLung Cancer
- Interventions
- Diagnostic Test: CT scans 2D ReconstructionDiagnostic Test: CT scans 2D plus 3D Reconstruction
- Registration Number
- NCT05716815
- Lead Sponsor
- Ospedale Centrale Bolzano
- Brief Summary
With this project we want to study the effectiveness of 3D reconstruction of preoperative CT to reduce operating times, blood loss and conversions after segmentectomy performed in thoracoscopy / robotics.
- Detailed Description
Pulmonary segmentectomy is the surgery of first choice in malignant lung tumors with a diameter \<2 cm in diameter. Patients who are candidates for this type of treatment perform usually a preoperative CT scan with two-dimensional reconstructions (2D: axial, coronary and sagittal). Today it is possible to perform a preoperative three-dimensional reconstruction (3D: volume rendering) of the vessels and bronchi using special software.
Objectives of the study is to analyze, in these patients, the benefits of 3D reconstruction of vessels and bronchi compared to 2D reconstruction, analyzing intra- and post-operative data.The study aims to randomize 288 patients over 36 months.
Study design: Prospective, randomized, controlled study. In 50% of patients the preoperative study of anatomical structures will be performed with the standard 2D method, in the remaining 50% with a 2D and 3D reconstruction. The assignment will take place through access to an online feature on the study website.
Evaluations and statistical methods The statistical analysis will be carried out using parametric and nonparametric descriptive, inferential statistical methods, while the main outcome will be carried out using the analysis of variance (ANOVA) and covariance (ANCOVA) techniques.
Ethical aspects. The study will be conducted in accordance with applicable current legislation. Approval by all relevant ethics committees will be required. Each patient will provide a written consent to participate in the study, after being properly informed.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 288
- Segmentectomy performed through a minimally invasive approach (VATS or RATS).
- Pathologically proven NSCLC on the resected specimen.
- Age ≥18
- Signed written informed consent
- Prior homolateral cardiothoracic surgery.
- Allergy or any other contraindication to iodinated contrast media.
- Segmentectomy performed through an open approach (thoracotomy)
- Histology different than NSCLC.
- Pregnancy
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description 2D Reconstruction CT scans 2D Reconstruction Before minimally invasive lung segmentectomy, preoperative chest CT scans are processed and evaluated with multi-plane (2D) reconstructions, according to the usual center protocol. 2D plus 3D Reconstruction CT scans 2D plus 3D Reconstruction Before minimally invasive lung segmentectomy, preoperative chest CT scans are processed and evaluated with volume rendering (3D) reconstructions.
- Primary Outcome Measures
Name Time Method Margin- and disease-free resection 1 Month postoperative Margin- and disease-free resection
Conversions from minimally invasive to thoracotomic procedure Intraoperative Evaluation of conversions from minimally invasive to thoracotomic procedure
- Secondary Outcome Measures
Name Time Method Intraoperative air leaks and the use of sealants Intraoperative Evaluation of intraoperative air leaks and the use of sealants
Intraoperative major bleeding Intraoperative Intraoperative major bleeding
Operating times Intraoperative Evaluation of operating times
Intraoperative blood loss Intraoperative Evaluation of intraoperative blood loss
Postoperative air leaks up to 2 weeks Evaluation of postoperative air leaks
Hospitalization times up to 3 weeks Evaluation of hospitalization times