Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

All Conditions

Lung Neoplasms

Pneumothorax

Pleural Diseases

Respiratory Tract Diseases

Participants will have their body re-positioned upon being transferred to the stretcher from the CT scanner table such that the biopsy site is down. Participants will be maintained in the same position for the post-biopsy CT scanner as well as in the post-procedure recovery area for a minimum of 2 hours.

CT-guided lung biopsy will be performed per standard protocols

Repositioning of the participant post biopsy

Rapid Rollover

Jae Ho Sohn, MD

Xiao Wu, MD

Pneumothorax is the most common complication after CT-guided lung biopsy, and several techniques have been proposed to reduce the risk. Among them, rapid rollover is the maneuver to immediately reposition the patient, with biopsy-side down after removal of biopsy needle. It has been theorized that the technique reduces the size of alveoli surrounding the needle tract, leading to airway closure and reduction in the alveolar-to-pleural pressure gradient, thereby preventing pneumothorax. The aim of this study is to evaluate the effectiveness of rapid rollover in reducing the risk of radiographically detectable pneumothorax and the rate of chest tube insertion.

Patients undergoing CT-guided lung biopsy for any indication will be recruited and randomized into either rapid rollover group or control group. In the control group, CT guided lung biopsy will be performed per standard protocols; in the rapid rollover group, the biopsy will also be performed per the same protocol with the addition of rapid rollover at the end of the procedure. For both groups, the primary outcome would be new or enlarging pneumothorax detected on post-biopsy radiographs, and the secondary outcome would be the risk of pneumothorax necessitating chest tube insertion, all complications associated with CT guided lung biopsy, time to complication development, and patient experience in each arm.

All patients will undergo CT-guided lung biopsy by the best approach decided by the primary operator. Randomization will be performed based on parity of patients' medical record numbers, which were assigned randomly at their first presentation. Patients with even medical record numbers will be assigned to the control group and patients with odd medical record number will be assigned to the intervention group.

In the rapid rollover group, patients will be repositioned upon being transferred from the CT scanner table to the stretcher such that the biopsy site is down. Patient in the intervention arm will be maintained in the same position in the post-procedure recovery area for at least 2 hours if patients can tolerate. Anyone who maintains the biopsy-site down position for at least 30 minutes after repositioning in the intervention group will be considered as completion of the intervention. Patients who are in the controlled arm may choose the most comfortable position per their preferences. All patients will be monitored for at least 2 hours, after which a 0-1 hour optional post-biopsy radiograph and 2-hour follow-up radiograph will be obtained to assess for pneumothorax per the standard current protocol. Further follow-up radiograph may be obtained if the patient did not receive the 0-1 hour radiograph and the 2-hour radiograph was positive for pneumothorax that is not large enough to require immediate chest tube insertion. Interpreting radiologists of the post-biopsy radiographs will be blinded to whether the patient is in the control or intervention group.

A survey will be given to the patients in post-anesthesia care unit by nurses before they are discharged.

Multiple patient-, lesion- and technique-specific factors will be recorded:

Patient-specific factors:

* Age
* Gender
* Indication of lung biopsy
* History of underlying lung disease
* History of tobacco use
* Prior lung surgery or radiation

Lesion-specific factors:

* Location
* Size
* Morphology
* Shortest distance from pleura Technique-specific factors
* Approach
* Patient positioning during procedure
* Number of times crossing the pleura
* Number of times crossing the fissure
* Number of fine needle aspirations (FNAs)
* Number of core biopsies
* Needle-path length
* Needle-pleura angle
* Co-axial size
* Duration of biopsy site down time and number of turns as tolerated by the patient
* Use of blood patch

Randomized controlled trial. Eligible patients will be randomized into either the control group (standard protocol CT-guided lung biopsy) or the rapid rollover group (immediate reposition with biopsy site down).

Interpreting radiologists of the post-biopsy CTs and radiographs will be blinded to whether the patient is in the control or intervention group.

Effect of Rapid Rollover on Pneumothorax After CT-Guided Lung Biopsy

Effect of Post-Procedural Rapid Rollover on Pneumothorax After Percutaneous CT-Guided Lung Biopsy: A Randomized Controlled Trial

New or enlarging pneumothorax (from intraprocedural CT) which is detectable on post biopsy radiograph. The size of the pneumothorax will be measured in terms of the distance between visceral and parietal pleura. The severity of pneumothorax will be assessed using CTCAE 5.0.

Pneumothorax that requires chest tube insertion or other operative interventions (or CTCAE 5.0 grade 2 and above). While the decision to intervene could be operator-dependent, chest tube insertion takes place at our institution for patients with 1) enlarging or symptomatic small pneumothorax, and 2) moderate pneumothorax regardless of symptoms.

Enlarging pneumothorax from baseline pneumothorax \> 3 mm (distance between visceral and parietal pleura measured on chest radiograph) accounting for redistribution of air and projection.

University of California, San Francisco

Carcinoma, Non-Small-Cell Lung

Patients are inserted the large size tube (28F).Patients undergo upper lobectomy are inserted one additional large size tube(28F,we named this tube upper tube).This group is planned to enroll 30 patients.

Patients are inserted the small size tube connects with a negative pressure ball(drainage ball).Patients undergo upper lobectomy are inserted one additional large size tube(28F,we named this tube upper tube).This group is planned to enroll 30 patients.

Patients in Group A are inserted the large size tube (28F).

Large size tube

Patients in Group B are inserted the small-bore tube connects with a negative pressure ball(drainage ball).

Drainage ball

Zhao Jun

Cui zihan

Comparing the influences of different chest tube managements for enhanced recovery program after video-Assisted thoracoscopic lobectomy.

The Enhanced Recovery Program has a series of observation data contains hospitalization days, adverse events, drainage, extubation, visual analogue scale(VAS) scores and the number of analgesic using.The investigators plan to enroll 60 patients and divide them into two groups to compare the influences of different chest tube managements for enhanced recovery program after video-assisted thoracoscopic lobectomy.

Total 60 patients accept video-Assisted thoracoscopic lobectomy are divided into two groups(Group A and Group B) equally and randomly.Different group takes different chest tube managements.

The Affection of Two Chest Management for Enhanced Recovery Program After Video-assisted Thoracoscopic Lobectomy.

Comparison of the Results of Two Chest Tube Management During an Enhanced Recovery Program After Video-Assisted Thoracoscopic Lobectomy.

The numbers of days of patients stay in the hospital after surgery

VAS(Visual Analogue Score) is a method to value the degree of patient's pain after surgery.This method has a scale range from 1 to 10.Patient chose a number from it to represent his(her) pain.The "1" represents painless and the "10" represents sever pain which he(she) unable to bear. The pain is increasing with the increasing of number.

The number of analgesics using after surgery.

Air-leakage or seepage from the surrounding of tube.

The First Affiliated Hospital of Soochow University

patients managed with an electronic chest drainage system

patients managed with a traditional analogue chest drainage system

Patients in the intervention arm are connected to Thopaz, electronic drainage system immediately after closure of the chest, patients in the control group are connected to a traditional system. Chest tubes in both groups are then connected to suction of -20 cmH2O and maintained at that level until post-operative day #1.

On the morning of post-operative day #1, presence of air leak will be recorded on suction. Then, suction will be decreased to -8 cmH2O (so-called water seal). At that time, management of chest tube drainage and decision for chest tube removal will be dictated by clinical signs, symptoms, and surgeon preference following the standard clinical algorithm for post-operative care of general thoracic patients

electronic chest drainage system

Cecilia Pompili, MD

This study is designed to compare the Thopaz chest tube drainage system to the traditional collection chamber system. The Thopaz system is already in clinical use in the United States and throughout the world. As such, this study is not evaluating safety or efficacy of this system both of which have already been demonstrated. This study's primary aim is to determine whether the use of a digital chest drainage system compared with a traditional system affects duration of chest drainage and length of hospital stay.

Furthermore, we aim to determine whether the use of a digital chest drainage system compared with a traditional system increases the total distance of ambulation in the first 48 hours after thoracic surgery and affects overall patient satisfaction in the peri-operative period.

Finally, we want to determine whether the aforementioned outcomes relative to the chest tube drainage systems differ in different parts of the world.

Objective and Subjective Outcomes of an Electronic Chest Drainage System

Objective and Subjective Outcomes of an Electronic Chest Drainage System Versus Traditional Devices: a Randomized Comparison

The Leeds Teaching Hospitals NHS Trust

The University of Hong Kong

Yale University

Ospedali Riuniti Ancona

Heart and Blood Diseases

Pulmonary Embolism

Embolism

Pleural Effusion

Pharmaceutical Solutions

All Drugs and Chemicals

Fibrinolytic Agents

Tissue Plasminogen Activator

10mg of t-PA and 5 mg of DNase in a 30 mL solution of water/saline administered via chest tube over three days twice daily 24-48 hours after chest tube placed.

10mg of t-PA and 5 mg of DNase in a 30 mL solution of water/saline administered via chest tube over three days twice daily with initial administration occurring at chest tube placement.

Early addition of tPA and DNase (immediately at chest tube placement) versus later (24-48 hours) after chest tube placement.

early tPA and DNase

Rohan Mankikar, MD

Chest tubes are used for air or fluid removal from the pleural space. When a chest tube is placed, it can be hard for the fluid to drain.Tissue plasminogen activator (tPA) and DNase are given through the chest tube to help with draining the fluid. We are doing this research to see if early addition of tPA-DNase immediately after chest tube placement will help with better fluid draining.

The purpose of this study is to determine the timing and efficacy of early administration and late administration of t-PA/DNase via thoracostomy (n=60). Patients will be identified from the Intensive Care Unit, Coronary Care Unit, and wards/stepdown units. Prior to chest tube placement, patients will be randomized to one of the two treatment arms (early use of t-PA-DNase verus late use of t-PA-DNase). Route of administration will be via their thoracostomy tube over a period of three days twice daily.

Early Intrapleural TPA Instillation Versus Late

Volume of fluid drained after each tPA and DNase instillation

Post tPA/DNase administration, the need for other interventions, such as surgery or additional chest tube, will be determined.

Prisma Health-Midlands

Principal Investigator

Symptoms and General Pathology

Pleural Effusion, Malignant

Cancer Pain

Pain

Pleural Neoplasms

Respiratory Tract Neoplasms

Thoracic Neoplasms

Anti-Inflammatory Agents

Antirheumatic Agents

Analgesics

Central Nervous System Depressants

Ibuprofen

Morphine

Opiate Alkaloids

Anti-Inflammatory Agents, Non-Steroidal

Analgesics, Non-Narcotic

Analgesics, Opioid

Narcotics

Chest tube greater than 14 French size and ibuprofen.

Large bore chest drain + NSAID based analgesic regimen

Chest tube less than or equal to 14 French size and ibuprofen.

Small bore chest drain + NSAID based analgesic regimen

Chest tube greater than 14 French size and morphine.

Large bore chest drain + opiate based analgesic regimen

Chest tube less than or equal to 14 French size and morphine.

Small bore chest drain + opiate based analgesic regimen

RJO Davies, Dr.

Fluid caused by cancer cells may accumulate in the lining of the lung. Draining the fluid with a chest tube may relieve pain and shortness of breath. To stop the fluid from coming back again, patients are given a medicine (talc) into the chest drain to seal up the space around the lung. This procedure is known as pleurodesis. This sometimes causes pain and discomfort, and the investigators do not know the best way of preventing this.

The investigators hope to find the best way to prevent pain during pleurodesis.

Patients with metastatic cancer often have fluid collecting around the lung as a result of cancer cells spreading to the membranes adjacent to the lung (malignant pleural effusion). The standard way of treating this condition, which may cause unpleasant symptoms such as breathlessness and cough, is to drain the fluid off and then seal the cavity, using a drug (talc) given into the chest drain. Talc causes inflammation in the lining of the lung and chest wall, sticking the two surfaces together and preventing fluid from recurring. This procedure is often very painful; the pain may be partly related to the size of the chest tube used and the type of analgesia taken by the patient during the procedure. Reducing the amount of pain associated with this procedure would be a substantial benefit for patients undergoing this procedure.

This trial is looking at which of two different drug regimens is more effective in preventing pleurodesis pain, and whether the size of chest tube influences pain. It will also address whether either of these influences success rate of pleurodesis.

We hope to learn whether the size of chest drain or the type of pain medication given (ibuprofen or morphine) influences the amount of pain felt after the pleurodesis procedure. We hope to find the best way of preventing pain during this procedure.

The First Therapeutic Intervention in Malignant Pleural Effusion Trial

TIME1: A 2 X 2 Factorial Trial to Assess Whether Non-steroidal Anti-inflammatory Analgesics and Small-bore Chest Tubes Are Less Painful Than Opiate Analgesics and Large-bore Chest Tubes in Pleurodesis for Malignant Pleural Effusion.

University of California, Davis

Multiple Pulmonary Nodules

Solitary Pulmonary Nodule

Lung Diseases

Interventions: VATS without chest tube placement

chest tube

Patient received Video-Assisted Thoracic Surgery (VATS) wedge resection for peripheral lung nodule without chest tube placement (Tubeless)

VATS without chest tube placement

VATS with chest tube placement

Jin-Shing Chen, MD, PhD

Chest tube placement after thoracoscopy surgery had been generally accepted as routine procedure for removal of the residual intrapleural fluid and air, however, it would cause post-operative pain, prohibit ambulation after surgery, and prolong the hospital stay. According to the recent studies, omission of chest tube placement after minor thoracoscopic procedures (such as pulmonary wedge resection) had been safe and feasible, and it also reduced the post-operative pain and shortened the hospital stay. We will conduct a prospective randomized trial in National Taiwan University Hospital.

We will enroll 100 patients with peripheral lung nodule who will be randomly assigned to no chest tube placement (tubeless group) or chest tube placement (control group) after thoracoscopic wedge resection with out without lymph adenectomy. The primary endpoints are to compare the post-operative hospital stay and post-operative pain sale between the two groups. The secondary endpoints are to compare the intercostal neuralgia and wound satisfaction one month after surgery between the two groups.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Effect of Rapid Rollover on Pneumothorax After CT-Guided Lung Biopsy	NCT05342675	Lung Cancer Pneumothorax	Rapid Rollover	18 Years -	University of California, San Francisco
The Affection of Two Chest Management for Enhanced Recovery Program After Video-assisted Thoracoscopic Lobectomy.	NCT03598296	Chest Tube	Large size tube Drainage ball	30 Years - 70 Years	The First Affiliated Hospital of Soochow University
Objective and Subjective Outcomes of an Electronic Chest Drainage System	NCT01747889	Lung Cancer	electronic ches...	18 Years - 90 Years	Ospedali Riuniti Ancona
Objective and Subjective Outcomes of an Electronic Chest Drainage System	NCT01747889	Lung Cancer	electronic ches...	18 Years - 90 Years	Ospedali Riuniti Ancona
Early Intrapleural TPA Instillation Versus Late	NCT03167281	Tissue Plasmino...	early tPA and D...	18 Years - 100 Years	Prisma Health-Midlands
The First Therapeutic Intervention in Malignant Pleural Effusion Trial	NCT00896285	Malignant Pleur... Pleural Effusio...	Large bore ches... Small bore ches... Large bore ches... Small bore ches...	18 Years -	University of California, Davis
Tubeless VATS for Peripheral Lung Nodule	NCT02817048	Solitary Pulmon...	chest tube VATS without ch... VATS with chest...	20 Years - 80 Years	National Taiwan University Hospital
The Affection of Two Chest Management for Enhanced Recovery Program After Video-assisted Thoracoscopic Lobectomy.	NCT03598296	Chest Tube	Large size tube Drainage ball	30 Years - 70 Years	The First Affiliated Hospital of Soochow University
Effect of Rapid Rollover on Pneumothorax After CT-Guided Lung Biopsy	NCT05342675	Lung Cancer Pneumothorax	Rapid Rollover	18 Years -	University of California, San Francisco

Spots Global Cancer Trial Database for chest tube

Every month we try and update this database with for chest tube cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for chest tube

Every month we try and update this database with for chest tube cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for chest tube cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.