The Application Value of Intercostal Suturing in Preventing Postoperative Thoracoscopic Lung Resection Chest Wall Pulmonary Hernia
Trial Snapshot
- Phase
- Not Applicable
- Status
- Enrolling By Invitation
- Sponsor
- Enrollment
- 104
- Locations
- 1
- Primary Endpoint
- Postoperative chest CT at 3 months
Study Overview
Brief Summary
The purpose of this trial is to understand whether intercostal suture can effectively prevent postoperative chest wall lung herniation, mainly to verify the following questions Can intercostal suture reduce postoperative chest wall lung herniation The hemostatic effect and hemostatic time of intercostal suture on intercostal muscle incision bleeding during surgery The researchers will divide the participants into two groups, one group will receive intercostal suture, and the other group will not receive intercostal suture, that is, conventional suture The participants will Receive or not receive intercostal suture during surgery Hemostatic effect and hemostasis time of rib intermuscular incision bleeding during surgery Chest CT will be reviewed 3 months after surgery to observe the chest wall incision
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Double (Care Provider, Investigator)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- Male
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients undergoing lung resection via multiport thoracoscopic surgery
- •Age greater than or equal to 18 years
- •No history of thoracic surgery
Exclusion Criteria
- •Be converted to a thoracoscopic-assisted mini-thoracotomy,a rib retractor becomes necessary.
- •Be converted to thoracotomy or a conventional posterolateral incision may be necessary based on the specific intraoperative circumstances.
- •Uniportal thoracoscopic surgery
- •History of ipsilateral thoracic surgery
Arms & Interventions
Experimental group
After the lung resection-related operations are completed, the chest cavity is properly hemostatic, and the incision protective cover of the relevant operation hole is removed. If there is bleeding in the incision, use electrocoagulation to fully stop the bleeding. After hemostasis is completed, use a ligature suture guide to clamp a 1-0 PDS absorbable suture and insert it into the upper intercostal space on the head side of the main operation port. In the secondary operation space, use a double-jointed separation forceps to grasp the suture in the chest cavity and then detach the suture from the ligature suture guide. At this time, insert the ligature suture guide into the lower intercostal space on the foot side of the main operation port. The suture is clamped by the separation forceps in the chest cavity and then pulled out of the chest cavity after being clamped by the claws of the ligature suture guide. In this way, continuous sutures are performed in sequence for a total of 5 s
Intervention: Intercostal suture (Procedure)
Control group
After the lung resection operation is completed, the chest cavity is properly hemostatic, and the incision protective cover of the relevant operation hole is removed. If there is bleeding in the incision, electrocoagulation is used to fully stop the bleeding. After the hemostasis is completed, the chest wall muscle group and subcutaneous tissue layer are sutured once with a double-needle barbed suture made of 2-gauge PDO material. Finally, the skin is sutured with ordinary silk thread interrupted sutures or absorbable sutures are used to continuously suture the skin intradermally to complete the chest closure.
Outcomes
Primary Outcomes
Postoperative chest CT at 3 months
Time Frame: From enrollment to the end of treatment at 3 months
Postoperative follow-up chest CT:If the CT indicates that the lung tissue at the main incision site has herniated through the intercostal space to the outside of the rib bony structure,it is considered positive;otherwise,it is negative.
Hemostasis time
Time Frame: From enrollment to the end of surgery
Record the bleeding condition at the intercostal incision. If there is bleeding at the intercostal incision, record the hemostasis time in detail.
Secondary Outcomes
- Postoperative drainage volume within 3 days(Postoperative Day 1,Day 2,Day 3)
Investigators
Mingjian Ge
Chief physician;Professor
First Affiliated Hospital of Chongqing Medical University