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This study evaluates the viability and safety of two-lumen catheterization versus complete omission of chest tube in patients with lung wedge resection. Half of participants will receive complete omission of chest tube, while the other half will receive a two-lumen central venous catheterization along the midclavicular line, second intercostal space for remedial gas-remove.
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% cases, and some of them need re-intervention. Hence, the investigators designed a intra-operative two-lumen catheterization as improved drainage strategy. Therefore, this study evaluates the viability and safety of two-lumen catheterization versus omission of chest tube placement in patients with lung wedge resection.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Omission of chest tube | Other | After wedge resection and the air-leak test, patients will receive complete omission of chest tube and directly close the incision. |
|
| Improved drainage strategy | Experimental | After wedge resection and the air-leak test, patients willreceive a two-lumen central venous catheterization along the midclavicular line, second intercostal space for remedial gas-removal. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Complete omission of chest tube | Procedure | No chest tube implacement |
| |
| Measure | Description | Time Frame |
|---|---|---|
| The incidence rate of massive pneumothorax on day 1 after surgery | To evaluate the incidence rate of pneumothorax (a pneumothorax greater than 2.0 cm on X-ray) | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| Pain score on day 1 after surgery | To evaluate the pain score via numerical rating scale on day 1 after surgery. An 11-point numeric scale (NRS 11) with 0 representing no pain and 10 representing worst pain imaginable. | 1 day |
| Length of post-operative hospital stay |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jia-Tao Zhang, Ph.D | Contact | +86-83827812-51311 | 18820792959@163.com | |
| Wen-Zhao Zhong, Ph.D | Contact | 13609777314@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Song Dong | Guangdong Provincial People's Hospital | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30187689 | Background | Zhang JT, Tang YC, Lin JT, Dong S, Nie Q, Jiang BY, Yan HH, Wen ZW, Wu Y, Yang XN, Wu YL, Zhong WZ. Prophylactic air-extraction strategy after thoracoscopic wedge resection. Thorac Cancer. 2018 Nov;9(11):1406-1412. doi: 10.1111/1759-7714.12850. Epub 2018 Sep 6. |
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| Improved drainage strategy |
| Procedure |
A two-lumen central venous catheterization along the midclavicular line, second intercostal space for remedial gas-remove |
|
To evaluate the length of post-operative hospital stay. |
| 1 week |
| Postoperative pulmonary function recovery | To evaluate the postoperative cardiopulmonary function recovery via 6-minute walk test in both groups. | 1 month |