Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

All Conditions

Symptoms and General Pathology

Lung Neoplasms

Pain

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

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

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

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 air leak test

Intraoperative chest drain removal

Standard chest drain placement

René H Petersen, MD, PhD

Thomas D Christensen, MD, PhD

Bo L Holbek, MD, PhD

Morten Bendixen, MD, PhD

Jonas J Rasmussen, MD

Henrik Kehlet, MD, PhD

Henrik J Hansen, MD

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.

Chest dRain rEmoval intrAoperatively afTer thoracOscopic Wedge Resection

Efficacy of Avoiding Chest Drain After Video-assisted Thoracoscopic Surgery Wedge Resection

All IPD that underlie results in a publication are planned to share to other researchers if they connect with the corresponding author of the publication.

Postoperative pain assessed in three different situations (at rest, arms lifted and during cough) by questionnaire at 3 and 6 hours after surgery, and on the morning of postoperative day 1 at 8 a.m

The amount of rescue analgesics given assessed as cumulative amount of morphine during the first 24 hours after surgery milligram equivalents (MME) as defined by pro.medicine.dk hosted by the Danish Association of the Pharmaceutical Industry

Number and size of pneumothorax at 6 hours after surgery in the drain-free group, 2 hours after drain removal in the drain group, and postoperative 2-week for both

Surgical and medical complications including mortality

Number and reasons of chest drain reinsertion

Days to meet discharge criteria but stay in hospital

Evaluate patients' quality of life by questionnaire before surgery, at the first day after surgery

Number of patients who did not receive planned postoperative analgesics according to the standards at their institution

Postoperative pain assessed in three different situations (at rest, arms lifted and during cough) by questionnaire from postoperative day 2 to 6.

Spots Global Cancer Trial Database for standard chest drain placement