Chest dRain rEmoval intrAoperatively afTer thoracOscopic Wedge Resection

NCT ID: NCT05358158

Last Updated: 2024-03-20

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

COMPLETED

Clinical Phase

NA

Total Enrollment

94 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-05-04

Study Completion Date

2024-03-17

Brief Summary

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Chest drain is used routinely after lung surgery. Despite preliminary studies demonstrate the feasibility and safety of intraoperative chest drain removal, these are either retrospective or mainly concerning benign disease.

Hypothesis: Participants treated without post-operative chest tube after thoracoscopic wedge resection have less pain, reduced opioid usage without increasing postoperative complications than participants treated with standard post-operative chest tube, and could possibly be discharged earlier.

Detailed Description

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Conditions

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Lung Neoplasms Lung Surgery Enhanced Recovery After Surgery Fast-track Surgery Pain Opioid Use Remission

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Drain-free group

Participants undergoing video-assisted thoracoscopic wedge resection with a positive intraoperative sealing test are treated with intraoperative chest tube removal.

Group Type EXPERIMENTAL

Intraoperative air leak test

Intervention Type PROCEDURE

A standard 28 Fr chest drain is inserted through the anterior port hole with all port holes closed. With the tip of the chest tube below water, the pleura is emptied from air during continuous ventilation of the lungs. An air leak after 5 minutes of ventilation indicates a negative sealing test, whereas a cessation of air leak within 5 minutes indicates a positive sealing test.

Intraoperative chest drain removal

Intervention Type PROCEDURE

Chest drain is removed intraoperatively.

Chest drain group

Participants undergoing video-assisted thoracoscopic wedge resection with a positive intraoperative sealing test are treated with a standard postoperative chest tube.

Group Type ACTIVE_COMPARATOR

Intraoperative air leak test

Intervention Type PROCEDURE

A standard 28 Fr chest drain is inserted through the anterior port hole with all port holes closed. With the tip of the chest tube below water, the pleura is emptied from air during continuous ventilation of the lungs. An air leak after 5 minutes of ventilation indicates a negative sealing test, whereas a cessation of air leak within 5 minutes indicates a positive sealing test.

Standard chest drain placement

Intervention Type PROCEDURE

Chest drain is left in pleura.

Interventions

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Intraoperative air leak test

A standard 28 Fr chest drain is inserted through the anterior port hole with all port holes closed. With the tip of the chest tube below water, the pleura is emptied from air during continuous ventilation of the lungs. An air leak after 5 minutes of ventilation indicates a negative sealing test, whereas a cessation of air leak within 5 minutes indicates a positive sealing test.

Intervention Type PROCEDURE

Intraoperative chest drain removal

Chest drain is removed intraoperatively.

Intervention Type PROCEDURE

Standard chest drain placement

Chest drain is left in pleura.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years.
* Patients referred for elective three port video-assisted thoracoscopic surgery wedge resection of the lung for suspected or confirmed malignant nodules.
* first second forced expiratory volume ≥60% of expected.
* No increased bleeding risk (e.g. preoperative international normalized ratio \>2, overdue discontinuation of anticoagulants according to guidelines by the Danish Society for Thrombosis and Haemostasis, known coagulopathy).
* Not scheduled for frozen section pathology of wedge resection and subsequent lobectomy.
* Able and willing to give informed consent.

Exclusion Criteria

* Increased risk of post-operative air leak assessed perioperatively by the surgeon (e.g. severe adhesions, bullous/emphysematous lung tissue, defects of the visceral pleura due to iatrogenic or other reasons, suturing in the lung tissue, deep lung resection).
* Increased risk of post-operative bleeding assessed perioperatively by the surgeon (e.g. intraoperative bleeding or oozing).
* Air leak during intraoperative air leak test.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Aarhus University Hospital

OTHER

Sponsor Role collaborator

Rigshospitalet, Denmark

OTHER

Sponsor Role lead

Responsible Party

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Lin Huang

Department of cardiothoracic surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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René H Petersen, MD, PhD

Role: STUDY_CHAIR

Rigshospitalet, Denmark

Thomas D Christensen, MD, PhD

Role: STUDY_DIRECTOR

Aarhus University Hospital

Bo L Holbek, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Rigshospitalet, Denmark

Morten Bendixen, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Aarhus University Hospital

Jonas J Rasmussen, MD

Role: PRINCIPAL_INVESTIGATOR

Aarhus University Hospital

Henrik Kehlet, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Rigshospitalet, Denmark

Henrik J Hansen, MD

Role: PRINCIPAL_INVESTIGATOR

Rigshospitalet, Denmark

Locations

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Thomas Decker Christensen

Aarhus, Aarhus N, Denmark

Site Status

Rigshospitalet

Copenhagen, , Denmark

Site Status

Countries

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Denmark

References

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Other Identifiers

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H-21012837

Identifier Type: -

Identifier Source: org_study_id

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