A Study to Evaluate Routine Chest Tube Management After Minimally Invasive Lung Surgery

NCT ID: NCT04913415

Last Updated: 2024-04-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-02-23

Study Completion Date

2024-08-31

Brief Summary

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Chest tubes are routinely required after surgical procedures for lung cancer. This device is a flexible plastic tube that is inserted through the chest wall to remove air or fluid from around your lungs after surgery for lung cancer. There are two general strategies associated with the clinical management of chest tubes, active and passive suction. If suction is compared to driving a car, active suction is similar to pressing the gas pedal while passive suction is like letting your car move on its own. The suction approach taken by surgeons largely depends on how they were trained and some personal biases and beliefs. However there is no general consensus about which chest tube management strategy is best.

This research aims to compare two settings on a digital drainage system, a low suction (LS) mode - passive suction - and standard suction (ss) mode - active suction. From the data collected, the researchers will analyze whether LS or SS will lead to a better recovery after surgery.

Detailed Description

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Conditions

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Lung Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Subjects will be randomized to either the Low Suction or Standard Suction chest tube management group
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Low Suction Strategy of Chest Tube Management

Group Type OTHER

Low Suction Strategy of Chest Tube Management

Intervention Type OTHER

A digital chest tube will be set to a low pressure mode (-8mmHg) during recovery after minimally invasive lung resection.

Standard Suction Strategy of Chest Tube Management

Group Type OTHER

Standard Suction Strategy of Chest Tube Management

Intervention Type OTHER

A digital chest tube will be to the standard suction mode (-20mmHg) during recovery after minimally invasive lung resection.

Interventions

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Low Suction Strategy of Chest Tube Management

A digital chest tube will be set to a low pressure mode (-8mmHg) during recovery after minimally invasive lung resection.

Intervention Type OTHER

Standard Suction Strategy of Chest Tube Management

A digital chest tube will be to the standard suction mode (-20mmHg) during recovery after minimally invasive lung resection.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Patients who are undergoing lobectomy or segmentectomy
2. Patients undergoing wedge resection to diagnose, or as definitive therapy for a lung nodule/cancer.
3. Able to understand and sign consent

Exclusion Criteria

1. Patients undergoing pneumonectomy or bilobectomy
2. Patients undergoing resection for inflammatory conditions such as aspergillosis
3. Patients undergoing diagnostic wedge resection for interstitial lung disease
4. Patients undergoing redo-VATS or thoracotomy on the same side as current planned resection
5. Patients found to have a "frozen chest" at the time of surgery, requiring extensive adhesiolysis,
6. Patients who are discovered to have metastatic disease during the operation, so that resection is no longer indicated.
7. Patients where a clinical decision to place more than one chest-tube is made
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute)

OTHER

Sponsor Role lead

Responsible Party

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Hiran Fernando, MD

Chief of Thoracic Surgery at Allegheny General Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hiran Fernando, M.D.

Role: PRINCIPAL_INVESTIGATOR

Allegheny Health Network

Locations

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Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status

Countries

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United States

References

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Mayor MA, Khandhar SJ, Chandy J, Fernando HC. Implementing a thoracic enhanced recovery with ambulation after surgery program: key aspects and challenges. J Thorac Dis. 2018 Nov;10(Suppl 32):S3809-S3814. doi: 10.21037/jtd.2018.10.106.

Reference Type RESULT
PMID: 30505568 (View on PubMed)

Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, Brunelli A, Cerfolio RJ, Gonzalez M, Ljungqvist O, Petersen RH, Popescu WM, Slinger PD, Naidu B. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS(R)) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg. 2019 Jan 1;55(1):91-115. doi: 10.1093/ejcts/ezy301.

Reference Type RESULT
PMID: 30304509 (View on PubMed)

Cerfolio RJ, Bass C, Katholi CR. Prospective randomized trial compares suction versus water seal for air leaks. Ann Thorac Surg. 2001 May;71(5):1613-7. doi: 10.1016/s0003-4975(01)02474-2.

Reference Type RESULT
PMID: 11383809 (View on PubMed)

Marshall MB, Deeb ME, Bleier JI, Kucharczuk JC, Friedberg JS, Kaiser LR, Shrager JB. Suction vs water seal after pulmonary resection: a randomized prospective study. Chest. 2002 Mar;121(3):831-5. doi: 10.1378/chest.121.3.831.

Reference Type RESULT
PMID: 11888968 (View on PubMed)

Cerfolio RJ, Bryant AS. The benefits of continuous and digital air leak assessment after elective pulmonary resection: a prospective study. Ann Thorac Surg. 2008 Aug;86(2):396-401. doi: 10.1016/j.athoracsur.2008.04.016.

Reference Type RESULT
PMID: 18640304 (View on PubMed)

Pompili C, Detterbeck F, Papagiannopoulos K, Sihoe A, Vachlas K, Maxfield MW, Lim HC, Brunelli A. Multicenter international randomized comparison of objective and subjective outcomes between electronic and traditional chest drainage systems. Ann Thorac Surg. 2014 Aug;98(2):490-6; discussion 496-7. doi: 10.1016/j.athoracsur.2014.03.043. Epub 2014 Jun 4.

Reference Type RESULT
PMID: 24906602 (View on PubMed)

Brunelli A, Salati M, Pompili C, Refai M, Sabbatini A. Regulated tailored suction vs regulated seal: a prospective randomized trial on air leak duration. Eur J Cardiothorac Surg. 2013 May;43(5):899-904. doi: 10.1093/ejcts/ezs518. Epub 2012 Sep 28.

Reference Type RESULT
PMID: 23024236 (View on PubMed)

Lijkendijk M, Licht PB, Neckelmann K. The Influence of Suction on Chest Drain Duration After Lobectomy Using Electronic Chest Drainage. Ann Thorac Surg. 2019 Jun;107(6):1621-1625. doi: 10.1016/j.athoracsur.2018.12.059. Epub 2019 Feb 8.

Reference Type RESULT
PMID: 30742815 (View on PubMed)

Holbek BL, Christensen M, Hansen HJ, Kehlet H, Petersen RH. The effects of low suction on digital drainage devices after lobectomy using video-assisted thoracoscopic surgery: a randomized controlled trialdagger. Eur J Cardiothorac Surg. 2019 Apr 1;55(4):673-681. doi: 10.1093/ejcts/ezy361.

Reference Type RESULT
PMID: 30445572 (View on PubMed)

Other Identifiers

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2021-005

Identifier Type: -

Identifier Source: org_study_id

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