Trial Outcomes & Findings for Powered Echelon Device in VATS Surgery (NCT NCT01843192)

NCT ID: NCT01843192

Last Updated: 2015-06-18

Results Overview

Air leak was to be quantitatively assessed starting on the evening after surgery and then twice daily (during morning and evening rounds) as described by Certfolio et al. 2001. Patients were instructed to perform standardized repeated forced expiratory maneuvers (coughing and blowing). Leaks were scored using the air-leak meter that comes as part of a pleura vac system from 1 to 7, with 7 being the highest (most chambers).

Recruitment status

COMPLETED

Target enrollment

71 participants

Primary outcome timeframe

Post-operative period through hospital discharge and follow-up at Day 30

Results posted on

2015-06-18

Participant Flow

Individuals undergoing VATS lobectomy for suspected or confirmed Non-small Cell Lung Cancer, or individuals undergoing VATS diagnostic wedge resection in accordance with their institution's Standard of Care, and who meet study entry criteria, were enrolled in this study.

There was no assignment to treatment group given that this is a single arm study wherein the same device was used on all subjects. Results are presented for the overall cohort as well as by the individual procedure performed - lobectomy, wedge resection, or wedge resection with lobectomy.

Participant milestones

Participant milestones
Measure
Wedge Resection
Subjects undergoing VATS wedge resection
Lobectomy
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
Subjects undergoing VATS wedge resection that also required lobectomy
Overall Study
STARTED
26
34
11
Overall Study
COMPLETED
24
28
9
Overall Study
NOT COMPLETED
2
6
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Wedge Resection
Subjects undergoing VATS wedge resection
Lobectomy
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
Subjects undergoing VATS wedge resection that also required lobectomy
Overall Study
Intra-operative exclusions per protocol
2
6
2

Baseline Characteristics

Powered Echelon Device in VATS Surgery

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Wedge Resection
n=24 Participants
Subjects undergoing VATS wedge resection
Lobectomy
n=28 Participants
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=9 Participants
Subjects undergoing VATS wedge resection that also required lobectomy
Total
n=61 Participants
Total of all reporting groups
Age, Continuous
63.3 years
STANDARD_DEVIATION 10.02 • n=5 Participants
68.1 years
STANDARD_DEVIATION 7.26 • n=7 Participants
68.7 years
STANDARD_DEVIATION 5.72 • n=5 Participants
66.3 years
STANDARD_DEVIATION 8.51 • n=4 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
20 Participants
n=7 Participants
5 Participants
n=5 Participants
37 Participants
n=4 Participants
Sex: Female, Male
Male
12 Participants
n=5 Participants
8 Participants
n=7 Participants
4 Participants
n=5 Participants
24 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
24 Participants
n=5 Participants
28 Participants
n=7 Participants
9 Participants
n=5 Participants
61 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race (NIH/OMB)
White
23 Participants
n=5 Participants
27 Participants
n=7 Participants
9 Participants
n=5 Participants
59 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Region of Enrollment
United States
24 participants
n=5 Participants
28 participants
n=7 Participants
9 participants
n=5 Participants
61 participants
n=4 Participants

PRIMARY outcome

Timeframe: Post-operative period through hospital discharge and follow-up at Day 30

Population: All subjects who consented to the study, had surgery for wedge resection, lobectomy, or wedge resection with lobectomy and were not converted to an open procedure

Air leak was to be quantitatively assessed starting on the evening after surgery and then twice daily (during morning and evening rounds) as described by Certfolio et al. 2001. Patients were instructed to perform standardized repeated forced expiratory maneuvers (coughing and blowing). Leaks were scored using the air-leak meter that comes as part of a pleura vac system from 1 to 7, with 7 being the highest (most chambers).

Outcome measures

Outcome measures
Measure
Wedge Resection
n=24 Participants
Subjects undergoing VATS wedge resection
Lobectomy
n=28 Participants
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=9 Participants
Subjects undergoing VATS wedge resection that also required lobectomy
Occurrence of Postoperative Air Leaks
45.8 percentage of participants
Interval 25.6 to 67.2
67.9 percentage of participants
Interval 47.6 to 84.1
88.9 percentage of participants
Interval 51.8 to 99.7

PRIMARY outcome

Timeframe: Post-operative period through hospital discharge and follow-up at Day 30

Population: All subjects who consented to the study, had surgery for wedge resection, lobectomy, or wedge resection with lobectomy and were not converted to an open procedure

Prolonged air leaks defined as longer than 5 days in continuous duration. Air leak was to be quantitatively assessed starting on the evening after surgery and then twice daily (during morning and evening rounds) as described by Certfolio et al. 2001. Patients were instructed to perform standardized repeated forced expiratory maneuvers (coughing and blowing). Leaks were scored using the air-leak meter that comes as part of a pleura vac system from 1 to 7, with 7 being the highest (most chambers).

Outcome measures

Outcome measures
Measure
Wedge Resection
n=24 Participants
Subjects undergoing VATS wedge resection
Lobectomy
n=28 Participants
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=9 Participants
Subjects undergoing VATS wedge resection that also required lobectomy
Occurrence of Prolonged Air Leaks
4.2 percentage of participants
Interval 0.1 to 21.1
7.1 percentage of participants
Interval 0.9 to 23.5
22.2 percentage of participants
Interval 2.8 to 60.0

SECONDARY outcome

Timeframe: Post-operative period through hospital discharge and follow-up at Day 30

Population: All subjects who consented to the study, had surgery for wedge resection, lobectomy, or wedge resection with lobectomy and were not converted to an open procedure

Determined as the length of time in days from hospital admission to initial hospital discharge

Outcome measures

Outcome measures
Measure
Wedge Resection
n=24 Participants
Subjects undergoing VATS wedge resection
Lobectomy
n=28 Participants
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=9 Participants
Subjects undergoing VATS wedge resection that also required lobectomy
Length of Stay (LOS)
3.7 days
Standard Deviation 1.63
4.9 days
Standard Deviation 1.70
4.8 days
Standard Deviation 1.48

SECONDARY outcome

Timeframe: Blood loss intra-op and up to 5 days post-op

Population: All subjects who consented to the study, had surgery for wedge resection, lobectomy, or wedge resection with lobectomy and were not converted to an open procedure

Outcome measures

Outcome measures
Measure
Wedge Resection
n=24 Participants
Subjects undergoing VATS wedge resection
Lobectomy
n=28 Participants
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=9 Participants
Subjects undergoing VATS wedge resection that also required lobectomy
Volume of Estimated Intra-operative Blood Loss
31.5 milliliters
Standard Deviation 56.48
83.2 milliliters
Standard Deviation 62.42
86.1 milliliters
Standard Deviation 80.15

SECONDARY outcome

Timeframe: Post-operative period through hospital discharge and follow-up at Day 30

Population: All subjects who consented to the study, had surgery for wedge resection, lobectomy, or wedge resection with lobectomy and were not converted to an open procedure

Defined as the number of days from date of surgery to removal of the last chest tube inserted during the surgical procedure.

Outcome measures

Outcome measures
Measure
Wedge Resection
n=24 Participants
Subjects undergoing VATS wedge resection
Lobectomy
n=28 Participants
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=9 Participants
Subjects undergoing VATS wedge resection that also required lobectomy
Time to Chest Tube Removal
3.7 days
Standard Deviation 1.63
4.9 days
Standard Deviation 1.7
4.8 days
Standard Deviation 1.48

SECONDARY outcome

Timeframe: Day of surgery

Population: All subjects who consented to the study, had surgery for wedge resection, lobectomy, or wedge resection with lobectomy and were not converted to an open procedure

Defined as the duration in hours from the first skin incision to the closure of the last incision

Outcome measures

Outcome measures
Measure
Wedge Resection
n=24 Participants
Subjects undergoing VATS wedge resection
Lobectomy
n=28 Participants
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=9 Participants
Subjects undergoing VATS wedge resection that also required lobectomy
Operative Time
1.7 hours
Standard Deviation 0.68
2.8 hours
Standard Deviation 0.85
3.4 hours
Standard Deviation 1.43

SECONDARY outcome

Timeframe: During surgery

Population: All subjects who consented to the study, had surgery for wedge resection, lobectomy, or wedge resection with lobectomy and were not converted to an open procedure. This analysis was further restricted to those subjects in whom an intra-operative leak test was actually performed, as it was not standard of care at all participating institutions.

This outcome was scored as Yes or No based on whether a leak was detected during an intra-operative leak test when it was performed. Not all subjects had an intra-operative leak test performed, as it was not standard of care at all participating institutions, and so results are only presented for those subjects in whom an intra-operative test was performed.

Outcome measures

Outcome measures
Measure
Wedge Resection
n=2 Participants
Subjects undergoing VATS wedge resection
Lobectomy
n=12 Participants
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=3 Participants
Subjects undergoing VATS wedge resection that also required lobectomy
Occurrence of Intra-operative Leak Test
0 participants
0 participants
1 participants

SECONDARY outcome

Timeframe: During surgery

Population: All subjects who consented to the study, had surgery for wedge resection, lobectomy, or wedge resection with lobectomy and were not converted to an open procedure

All subjects had either 1 or 2 chest tubes placed during surgery. Results presented are for the percentage of subjects with 1 chest tube placed.

Outcome measures

Outcome measures
Measure
Wedge Resection
n=24 Participants
Subjects undergoing VATS wedge resection
Lobectomy
n=28 Participants
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=9 Participants
Subjects undergoing VATS wedge resection that also required lobectomy
Number of Subjects With 1 Chest Tube Placed
88.5 percentage of participants
100 percentage of participants
88.9 percentage of participants

Adverse Events

Wedge Resection

Serious events: 2 serious events
Other events: 8 other events
Deaths: 0 deaths

Lobectomy

Serious events: 4 serious events
Other events: 6 other events
Deaths: 0 deaths

Wedge Resection With Lobectomy

Serious events: 2 serious events
Other events: 3 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Wedge Resection
n=26 participants at risk
Subjects undergoing VATS wedge resection
Lobectomy
n=34 participants at risk
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=11 participants at risk
Subjects undergoing VATS wedge resection that also required lobectomy
Cardiac disorders
Atrial fibrillation
0.00%
0/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
2.9%
1/34 • Number of events 1 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Respiratory, thoracic and mediastinal disorders
Chylothorax
3.8%
1/26 • Number of events 1 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Respiratory, thoracic and mediastinal disorders
Pneumothorax
0.00%
0/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
2.9%
1/34 • Number of events 1 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Respiratory, thoracic and mediastinal disorders
Pulmonary air leakage
3.8%
1/26 • Number of events 1 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
2.9%
1/34 • Number of events 1 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
18.2%
2/11 • Number of events 2 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Vascular disorders
Haemorrhage
0.00%
0/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
2.9%
1/34 • Number of events 1 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery

Other adverse events

Other adverse events
Measure
Wedge Resection
n=26 participants at risk
Subjects undergoing VATS wedge resection
Lobectomy
n=34 participants at risk
Subjects undergoing VATS lobectomy
Wedge Resection With Lobectomy
n=11 participants at risk
Subjects undergoing VATS wedge resection that also required lobectomy
Skin and subcutaneous tissue disorders
Subcutaneous emphysema
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
5.9%
2/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
18.2%
2/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Injury, poisoning and procedural complications
Vascular injury
0.00%
0/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
5.9%
2/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Injury, poisoning and procedural complications
Corneal abrasion
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Infections and infestations
Urinary tract infection
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
2.9%
1/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Infections and infestations
Cellulitis
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Cardiac disorders
Atrial fibrillation
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
2.9%
1/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Cardiac disorders
Supraventricular extrasystoles
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Gastrointestinal disorders
Nausea
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
9.1%
1/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Gastrointestinal disorders
Vomiting
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Nervous system disorders
Headache
0.00%
0/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
9.1%
1/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Renal and urinary disorders
Renal cyst
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Respiratory, thoracic and mediastinal disorders
Dyspnoea exertional
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
Respiratory, thoracic and mediastinal disorders
Hypoxia
3.8%
1/26 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/34 • Duration of follow-up was scheduled through approximately 4 weeks post surgery
0.00%
0/11 • Duration of follow-up was scheduled through approximately 4 weeks post surgery

Additional Information

Michael Schwiers

Ethicon, part of Johnson & Johnson

Phone: 513-337-1172

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60