Two-Lumen Catheterization Versus Chest Tube Placement in Patients With Lung Wedge Resection: A Prospective Randomized Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Thoracic Surgery, Video-Assisted
- Sponsor
- Wen-zhao ZHONG
- Enrollment
- 96
- Locations
- 1
- Primary Endpoint
- Postoperative adverse event incidence rate
- Last Updated
- 7 years ago
Overview
Brief Summary
This study evaluates the viability and safety of two-lumen catheterization versus chest tube placement in patients with lung wedge resection. Half of participants will receive routine chest tube placement, 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\~40% cases, and some of them need re-intervention. Hence, the investigators designed a intra-operative two-lumen catheterization for remedial gas-remove. Therefore, this study evaluates the viability and safety of two-lumen catheterization versus chest tube placement in patients with lung wedge resection.
Investigators
Wen-zhao ZHONG
Guangdong General Hospital
Guangdong Provincial People's Hospital
Eligibility Criteria
Inclusion Criteria
- •Preoperative radiology revealed solitary peripheral pulmonary nodule, with both size and depth less than 3 cm
- •Lung wedge resection for tumor biopsy to elucidate drug resistant mechanism or confirm diagnosis
Exclusion Criteria
- •Previous ipsilateral thoracic surgery or extensive adhesion
- •Preoperative radiology revealed pneumonia or atelectasis
- •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).
- •Bleeding tendency or anticoagulant use
- •Pregnancy or breast feeding
- •Patient who can not sign permit
Outcomes
Primary Outcomes
Postoperative adverse event incidence rate
Time Frame: 1 months
To evaluate the incidence rate of pneumothorax (a pneumothorax greater than 2.0 cm on X-ray) or pleural effusion (\>800ml) in both groups.
Rate of post-operative related complications
Time Frame: 1 week
To evaluate the rate of post-operative related complications within 7 days of surgery
Length of post-operative hospital stay
Time Frame: 1 week
To evaluate the length of post-operative hospital stay
Secondary Outcomes
- The time of post-operative extubation(1 week)
- Postoperative pulmonary function recovery(1 week)
- Postoperative wound satisfaction(1 month)
- Postoperative pneumoderm incidence rate(3 days)
- Postoperative pain score(1 day)