Safety and feasibility of wedge resection and intrathoracic tumor resection without postoperative chest tube

JRCT ID: jRCT1030210541

Registered date:07/01/2022

Basic Information

• Recruitment status: Recruiting
• Health condition(s) or Problem(s) studied: Lung tumor, Primary spontaneous pneumothorax, Mediastinal tumor, Chest wall tumor
• Date of first enrollment: 01/12/2021
• Target sample size: 30
• Study type: Interventional

Intervention(s)

After resection of targeted tumor, the lung is immersed in warm sterile saline, ventilated at a maximum inspiratory pressure of 15 cmH2O, and examined for air leaks. If there is an air leak in this sealing test, this patient will be excluded from the study. A 20-Fr trocar catheter is placed in the thoracic cavity with continuous suction (7 cmH2O).
Patients are returned to the supine position after surgery. We check the lung expansion using a routine portable chest X-ray before awakening the patient from anesthesia. Confirming that the lung expansion is good and that there is no air leak, we remove the chest tube immediately after extubation in the operating room. If there are air leaks during this time, the patient will be excluded from the study, and the chest tube will be left in place.
Postoperative day 1:We assess wound pain using a numerical rating scale (NRS) the next morning. After checking lung expansion by a chest X-ray, the patient will be discharged.
Postoperative day 7:We assess the wound pain using a numerical rating scale and check lung expansion by a chest X-ray.

Outcome(s)

• Primary Outcome: Incidence of pneumothorax requiring chest tube reinsertion

Secondary Outcome

Postoperative hospitalization
Postoperative pain score

Key inclusion & exclusion criteria

• Age minimum: Not applicable
• Age maximum: Not applicable
• Gender: Both

Include criteria

Scheduled for non-anatomical lung resection
Scheduled for intrathoracic tumor biopsy/resection
Written, informed consent has been obtained.

Exclude criteria

Dense pleural adhesions (more than one lobe)
History of ipsilateral anatomical lung resection
Air leak intraoperative sealing test
Blood loss over 100 ml
Underlying lung disease (sever emphysema, interstitial pneumonia, etc)
Air leaks from the end of the surgery to awakening from anesthesia

Related Information

• Primary Sponsor: Igai Hitoshi
• Secondary Sponsor: Kamiyoshihara Mitsuhiro