Neoplasms

Symptoms and General Pathology

All Conditions

Respiratory Tract (Lung and Bronchial) Diseases

Neoplasm Metastasis

Lung Neoplasms

Pain

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

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

A standard 28 Fr chest tube is inserted through the anterior port hole and all port holes are 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 sealing test

A regular chest tube is left in the pleura.

Standard post-operative chest tube

Intraoperative chest tube removal

Bo L. Holbek, MD

Henrik J. Hansen, MD

René H. Petersen, MD

Henrik Kehlet, DMSc

Chest tubes are used routinely although preliminary studies demonstrate the feasibility and safety of intraoperative chest drain removal. Previous studies are however either retrospective or mainly concerning benign disease.

Hypothesis: Participants treated without post-operative chest tube after thoracoscopic wedge resection have less pain, better pulmonary function and similar complication profile than participants treated with standard post-operative chest tube, and could possibly be discharged earlier.

Randomization occurs after ended surgery, thus masking allocation to the personnel and participant. After Randomization, there is no masking.

ThOracoscopic Wedge Resection Treated With Chest Tube Removal Intraoperatively

Pain and Reasons for Hospitalization in Patients Treated Without Post-operative Chest Tube After Thoracoscopic Wedge Resection - A Randomized Controlled Study

Average pain expressed as area under the curve from a numeric rank score at 1, 3, 6 and 9 hours after surgery as well as daily at 8 am and 8 pm from post-operative day 1 until discharge.

Daily evaluation of reasons for admission.

FEV1 measured preoperatively and on post-operative day 1 at 8 am.

Size and frequency of pneumothorax on x-ray after removal of chest tube

Surgical complications including mortality.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
ThOracoscopic Wedge Resection Treated With Chest Tube Removal Intraoperatively	NCT02829736	Pain Decreased Lung ... Delayed Dischar...	Intraoperative ... Standard post-o... Intraoperative ...	18 Years -	Rigshospitalet, Denmark
ThOracoscopic Wedge Resection Treated With Chest Tube Removal Intraoperatively	NCT02829736	Pain Decreased Lung ... Delayed Dischar...	Intraoperative ... Standard post-o... Intraoperative ...	18 Years -	Rigshospitalet, Denmark

Spots Global Cancer Trial Database for intraoperative sealing test