Symptoms and General Pathology

All Conditions

Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

Nervous System Diseases

Pain, Postoperative

Lung Neoplasms

Pain

Postoperative Complications

Neurologic Manifestations

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

The thoracic drainage tube is fixed on the muscle layer of the uniport

muscle layer fixation of thoracic drainage tube

Kun Li, MD

Kejie Huang, Bachelor

Lung cancer is the leading cause of cancer-related death worldwide. Thoracoscopic pulmonary resection is a prevalent management for early stage of lung cancer. Placement of chest tube is the standard procedure after surgery, which causes pain that cannot be ignored. The investigators aimed to determine whether a muscle layer fixation of thoracic drainage tube could release postoperative pain in patients with uniport thoracoscopic pulmonary resection compared with conventional skin fixation.

Effect of Muscle and Skin Fixation of Thoracic Drainage Tube on Postoperative Pain

Effect of Muscle and Skin Fixation of Thoracic Drainage Tube on Postoperative Pain in Patients Undergoing Uniport Thoracoscopic Pulmonary Resection

The postoperative pain is assessed using a Visual Analog Scale (VAS)

the level of pain-associated inflammatory factor in blood, including CRP, PCT, IL6 and TNFa

Daping Hospital and the Research Institute of Surgery of the Third Military Medical University

Mediastinal Neoplasms

Mediastinal Diseases

Thoracic Diseases

Thoracoscopic surgery performed with the fashion of single 2.5-3.5 cm intercostal incision and 1-2 additional 2-3 mmm needlescopic ports.

Conventional uniportal VATS with single 2.5-3.5 cm intercostal incision

Video-assisted thoracoscopic surgery for pulmonary or mediastinal lesions.

Thoracoscopic surgery

Chiu-kuei Nien

The investigators' study aims is to evaluate the safety and efficacy of uniportal VATS under assistance of needlescopic instruments through additional 2-3 mm ports compared to conventional uniportal VATS in patients with lung lesions.

Needlescopic-assisted Uniportal vs Uniportal VATS

Needlescopic-assisted Uniportal VATS Versus Conventional Uniportal VATS. A Randomized Prospective Noninferiority Study

Post-operative day 3 pain scale documented using Visual Analogue Scale (VAS)

Post-operative day 5 pain scale documented using Visual Analogue Scale (VAS)

Out patient documented using PainDETECT questionnaire (PD-Q)

Total opioid equivalent dose used during post-operative course

IRB of NTUH Hsin-Chu Branch

National Taiwan University Hospital Hsin-Chu Branch

After recruitment, participants will receive Tai Chi Exercise teaching. In the acupressure group, participants will receive acupressure treatment.

The experimental group will receive Tai Chi exercise and routine treatment after the operation, and after discharge from the hospital, they will perform Tai Chi exercise three times a week, 50 minutes each time, for a total of eight weeks after discharge.

Tai Chi Exercise

Hsin-Yuan Fang, Ph.D

Hsing-Chi Hsu, Ph.D

Kai-yu Tseng, Ph.D

To explore the effect of a family-centered, eight-week, progressive sit-to-stand Tai Chi exercise on lung function and mental health in patients after thoracoscopic surgery_

Lung cancer is the top death among cancers in Taiwan. The surgical excision of lung tissue is unable to regenerate new tissue after thoracoscopic lobectomy, resulting in decreased lung function and affecting health-related quality of life. 29% of female patients who received thoracic surgery tended to be anxious and depressed, and more than 60% of the family caregivers experienced mild to moderate caregiving burden and anxiety. Tai Chi exercise is a gentle exercise that can effectively enhance lung function. However, there is a lack of literature on the effects of Tai Chi exercise on lung function and mental health after thoracoscopic surgery.Methods: Exploratory sequential mixed methods study design will be used. The first phase will be a quasi-experimental study that will use purposive sampling to recruit thoracoscopic surgical patients and their family caregivers. It is estimated to enroll 60 pairs of patients and their family caregivers. The participants will be divided into experimental and control groups according to the sequential time of admission. The experimental group will receive Tai Chi exercise and routine treatment after the operation, and after discharge from the hospital, they will perform Tai Chi exercise three times a week, 50 minutes each time, for a total of eight weeks after discharge; the control group will receive conventional treatment. Repeated measures analysis of variance (repeated ANOVA) will be used for comparison between the experimental group and the control group and within the group; for other confounding factors, generalized estimating equations (GEE) will be used for analysis. In the second stage, after eight weeks of Tai Chi exercise, semi-structured interviews with about 10 patients and their caregivers will be conducted to collect their experiences and feelings related to the Tai Chi exercise. Qualitative data will be used to comprehend the quantitative data.

The Effects of a Family-Centered Tai Chi Exercise on Lung Function and Mental Health of Patients After Thoracoscopic Surgery

Vice Superintendent

data will be collected through lung function test

This scale measures the feelings of anxiety and stress that one has experienced in the past week. It has a total of 14 questions, including 7 questions each for the Anxiety Scale (HADS-A) and the Depression Scale (HADS-D). It is measured on a 4-point Likert scale. Score method (0-3), the total score of each item is 0-21 points, the higher the score measured by the scale, the higher the degree of anxiety and depression. The Cronbach's α coefficients of the internal consistency reliability of HADS-A and HADS-D are respectively 0.82-0.74, with high internal consistency.

China Medical University Hospital

Skin and Connective Tissue Diseases

Rare Diseases

Breast Neoplasms

Breast Neoplasms, Male

Breast Diseases

Skin Diseases

Breast Cancer, Male

Central Nervous System Depressants

All Drugs and Chemicals

Anesthetics

Technetium Tc 99m Sulfur Colloid

Radiopharmaceuticals

Administered pre-surgery; injection of 2 cc of Isosulfan Blue in four equal aliquots of 0.5 cc as routinely done for the axillary sentinel node procedure.

Isosulfan blue

Axillary Lymph Node Dissection

The surgery will be performed under general anesthesia with a single lumen endo-tracheal tube. The patient will be laid in a semi decubitus position on the opposite side with the ipsilateral arm bent over the head and attached to an arm rest.

Surgery

Sentinel Lymph Node Biopsy

Performed only if internal mammary sentinel node cannot be retrieved via same incision of lumpectomy/mastectomy.

Thoracoscopic Surgery

Two to three hours prior to surgery, a peritumoral injection of filtered Technetium Sulfur Colloid will be performed in four 0.25 mci/2cc aliquots

Eli Avisar, MD

RATIONALE: Diagnostic procedures, such as thoracoscopic sentinel lymph node biopsy, may help find breast cancer that has spread to lymph nodes between the breasts. It may also help doctors plan the best treatment.

PURPOSE: This clinical trial is studying how well thoracoscopic sentinel lymph node biopsy finds sentinel lymph nodes that are located between the breasts in patients with stage I or stage II breast cancer.

OBJECTIVES:

* Determine the occurrence rate of internal mammary sentinel lymph nodes in patients with medially or centrally located stage I or II breast cancer.
* Determine the safety, feasibility, and success rate of thorascopic internal mammary sentinel lymph node biopsy in these patients.
* Determine the rate of metastatic disease in internal mammary sentinel lymph nodes obtained thoracoscopically in these patients.

OUTLINE: Patients undergo standard axillary sentinel lymph node dissection during surgery (i.e., lumpectomy or mastectomy). Patients receive a radioactive tracer (i.e., technetium Tc 99m sulfur colloid) and isosulfan blue by peritumoral injection for identification of the axillary and internal mammary sentinel lymph nodes (IMSLN). Identified axillary sentinel lymph nodes are dissected. Identified IMSLNs are removed through the lumpectomy/mastectomy incision, if accessible. If they are not accessible, patients undergo thorascopic IMSLN biopsy to remove the nodes.

All removed sentinel lymph nodes (axillary or internal mammary) are examined for gross and microscopic carcinoma for future therapy planning.

PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.

Thoracoscopic Sentinel Lymph Node Biopsy in Patients With Stage I or Stage II Breast Cancer

Thoracoscopic Internal Mammary Sentinel Node Biopsy

University of Miami

Single Arm

Age, Categorical

Age, Continuous

Gender

United States

Region of Enrollment

A total of 39 subjects were enrolled however; only 34 of the subjects had identifiable internal mammary sentinel lymph nodes. As a result, the data of 34 subjects were analyzed.

Eli Avisar MD

Success Rate in Removing Sentinel Lymph Nodes by Thoracoscopy

Rate of Metastatic Disease in Internal Mammary Sentinel Lymph Nodes

Sentinel Lymph Node BIopsy

Of the 39 patients enrolled, 34 had identifiable internal mammary sentinel lymph nodes.

Number of Patients With Identifiable Internal Mammary Sentinel Lymph Nodes

Overall Study

Anti-Arrhythmia Agents

Channel Blockers

Lidocaine

Ropivacaine

Anesthetics, Local

In patients randomized to this Arm, before the induction of general anesthesia, the epidural catheter is placed in the intervertebral space (T4-T5, T5-6 or T6-T7) and used intra and post-operatively for administration of local anesthetics.

In patients randomized to this Arm, after induction of general anesthesia the Erector spinae plane (ESP) block is performed with a catheter introduced and left in place for continuous postoperative infusion of local anesthetics.

In patients randomized to this Arm, after induction of general anesthesia and single lung ventilation the first thoracoscopic surgical access is performed. A cryoanesthesia device with a dedicated atraumatic angled-tip cryoprobe is inserted through the thoracoscopic access and the active tip of the probe is positioned in contact with the intercostal nerves from T3 to T8.

The epidural catheter is placed while the patient is awake, before the induction of general anesthesia. The intervertebral spaces used for catheter insertion are alternatively T4-T5, T5-6 or T6-T7. After locating the epidural space through the technique of the loss of resistance, a catheter is introduced for about 5 cm and left in place for the administration of drugs into the epidural space. Once the correct functioning of the epidural catheter has been verified with a negative test for cerebrospinal fluid aspiration and a negative bolus test for the onset of signs and symptoms from intrathecal infusion, the catheter is used intraoperatively for administration of local anesthetics in refracted boluses (Lidocaine and Ropivacaine ) at anesthetic dosage and postoperatively for continuous infusion of Ropivacaine 0.15% at 5 mL/h.

Epidural

Erector spinae plane (ESP) block is performed after induction of general anesthesia, with the patient in a lateral decubitus position. With the aid of the ultrasound guide with linear probe, the transverse process of T5 ipsilateral to the site of the operation is identified. With the in-plane technique, the lower fascia of the ESP muscle is hydrodissected through the administration of Ropivacaine 0.5% 3 mg/Kg lean body weight. Subsequently, a catheter is introduced and left in place for continuous postoperative infusion of Ropivacaine 0.2% at 12 mL/h.

ESP block

Cryoanalgesia is performed after the induction of general anesthesia, single lung ventilation and after performing the first thoracoscopic surgical access. A cryoanesthesia device with a dedicated atraumatic angled-tip cryoprobe is inserted through the thoracoscopic access. The active tip of the probe is positioned in contact with the intercostal nerves from T3 to T8 and kept resting for 4 ½ minutes on each nerve at a temperature of -70°C, under direct thoracoscopic vision, generating an interruption of the sensory functions.

Cryoanalgesia

MARCO MAMMANA, MD, PhD

MARCO MAMMANA, MD,PhD

In patients undergoing minimally invasive thoracoscopic surgery (video-assisted thoracoscopic surgery, or VATS), moderate to severe post-operative pain may often be experienced. The presence of pain negatively affects the perceived quality of care and can predispose to complications, as the development of chronic pain.

In order to prevent post-operative pain, different multimodal pain treatment protocols are applied, consisting in combinations of local-regional anesthesiological techniques and intravenous medications.

Regional anesthesia is considered essential to prevent pain in the immediate post-operative period. However, to date, there is no agreement regarding which is the most effective regional anesthesiological technique; therefore, the choice is usually based on the Anesthetist's preferences.

The aim of this study is to compare three regional anesthesiological techniques (cryoanalgesia, epidural anesthesia, and erector spinae muscle plane block) routinely used during thoracoscopic lung surgery.

In patients undergoing minimally invasive thoracoscopic surgery (video-assisted thoracoscopic surgery, or VATS), moderate to severe post-operative pain may often be experienced. The presence of pain negatively affects the perceived quality of care and can predispose to complications, as the development of chronic pain.

In order to prevent post-operative pain, different multimodal pain treatment protocols are applied, consisting in combinations of local-regional anesthesiological techniques and intravenous medications.

Regional anesthesia is considered essential to prevent pain in the immediate post-operative period. However, to date, there is no agreement regarding which is the most effective regional anesthesiological technique; therefore, the choice is usually based on the Anesthetist's preferences.

The aim of this study is to compare three regional anesthesiological techniques (cryoanalgesia, epidural anesthesia, and erector spinae muscle plane block) routinely used during thoracoscopic lung surgery.

All patients undergoing anatomical pulmonary resections (lobectomy or segmentectomy) through a thoracoscopic (VATS) approach, and who present the inclusion/exclusion characteristics, will be considered.

The day of surgery, patients are randomized 1:1:1 to receive 3 different pain control techniques: epidural catheter, ESP block or cryoanalgesia.

A standard pain management protocol will be applied to all patient after surgery.

Primary Outcome Measure is the perceived post-operative pain 24 hours after surgery in the 3 groups, evaluated through numeric pain rating scale (NPRS). Other outcome measures are the post-operative pain trend and the patients' total amount of opioid use in the postoperative period (expressed as Morphine milligram equivalents).

Pain Control After VATS Anatomical Pulmonary Resections

Pain Control After VATS Anatomical Pulmonary Resections: Randomized Comparison Between Cryoanalgesia, Erector Spinae Plane Block and Epidural Catheter

Perceived post-operative pain 24 hours after surgery through Numeric Pain Rating Scale (NPRS, value from 0 to 10, o=no pain, 10=worst pain ever)

Perceived post-operative pain 1,6,12 and 48 hours after surgery through Numeric Pain Rating Scale (NPRS, value from 0 to 10, o=no pain, 10=worst pain ever)

patients' total amount of opioid use in the postoperative period (expressed as Morphine milligram equivalents)

University Hospital Padova

Thoracic Surgeon

Hemorrhage

The lobectomy will be preformed in case of an operable lung cancer. The thoracic surgery technique used is robot assisted thoracic surgery

Robot assited thoracic surgery

The lobectomy will be preformed in case of an operable lung cancer. The thoracic surgery technique used is video assisted thoracic surgery.

Video assited thoracic surgery

Veerle Van Mossevelde, data nurse

Dirk De Clippeleir, data nurse

Dirk Smets, MD

Wietske Renckens, meMD

Wietske Renckens, MD

Eef Vanderhelst, MD

In this study the investigator will compare the effectiveness of robot assisted thoracic surgery (RATS) with video assisted thoracic surgery (VATS) in case of lung cancer.

The perioperative circumstances and postoperative outcome will be compared.

Participants are randomly subdivided (1:1) to either undergo robot assisted lobectomy or video assisted thoracoscopic lobectomy in case of lung cancer. At the end of both surgical interventions the anaesthesiologist administers the same technique of pain relief: paravertebral blockage.

The data that are going to be investigated are: operative time, conversion to spreading of the ribs/thoracotomy, blood loss, lymph node dissection, prolonged air leak, chest tube drainage, length of stay, inflammatory reaction (through inflammatory parameters CRP, IL-3, IL-6, TNF), lung recuperation (through a lung function test) and postoperative pain (VAS score questionnaire).

Comparison of Robot Assisted Thoracic Surgery With Video Assisted Thoracic Surgery in Case of Lung Cancer

Comparison of Robot Assisted Thoracic Surgery With Video Assisted Thoracic Surgery in Case of Lung Cancer: a Prospective Trial With Control Group

0 = no pain 10 = unbearable pain: VASscore

duration of hospitalisation after surgery

recovery of function of the operated lung

these inflammatory parameters will be determined: C-reactive protein; IL-3; IL-6; TNF

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Effect of Muscle and Skin Fixation of Thoracic Drainage Tube on Postoperative Pain	NCT05202249	Lung Neoplasms Lung Cancer Pulmonary Neopl... Postoperative P... Thoracoscopic S...	muscle layer fi...	18 Years - 80 Years	Daping Hospital and the Research Institute of Surgery of the Third Military Medical University
Needlescopic-assisted Uniportal vs Uniportal VATS	NCT03439696	Lung Cancer Lung Cancer Met... Bullous Disease... Nodule Solitary... Mediastinal Tum...	Thoracoscopic s...	20 Years - 90 Years	National Taiwan University Hospital Hsin-Chu Branch
The Effects of a Family-Centered Tai Chi Exercise on Lung Function and Mental Health of Patients After Thoracoscopic Surgery	NCT06104774	Thoracic Neopla...	Tai Chi Exercis...	18 Years -	China Medical University Hospital
Effect of Muscle and Skin Fixation of Thoracic Drainage Tube on Postoperative Pain	NCT05202249	Lung Neoplasms Lung Cancer Pulmonary Neopl... Postoperative P... Thoracoscopic S...	muscle layer fi...	18 Years - 80 Years	Daping Hospital and the Research Institute of Surgery of the Third Military Medical University
Thoracoscopic Sentinel Lymph Node Biopsy in Patients With Stage I or Stage II Breast Cancer	NCT00450723	Breast Cancer	Isosulfan blue Axillary Lymph ... Surgery Sentinel Lymph ... Thoracoscopic S... Technetium Tc 9...	18 Years - 120 Years	University of Miami
Pain Control After VATS Anatomical Pulmonary Resections	NCT05993273	Lung Cancer Pain, Postopera... Thoracic Neopla...	Epidural ESP block Cryoanalgesia	18 Years -	University Hospital Padova
Comparison of Robot Assisted Thoracic Surgery With Video Assisted Thoracic Surgery in Case of Lung Cancer	NCT03152071	Lung Cancer Postoperative P... Blood Loss Inflammatory Re...	Robot assited t... Video assited t...	18 Years -	Universitair Ziekenhuis Brussel
Needlescopic-assisted Uniportal vs Uniportal VATS	NCT03439696	Lung Cancer Lung Cancer Met... Bullous Disease... Nodule Solitary... Mediastinal Tum...	Thoracoscopic s...	20 Years - 90 Years	National Taiwan University Hospital Hsin-Chu Branch
Comparison of Robot Assisted Thoracic Surgery With Video Assisted Thoracic Surgery in Case of Lung Cancer	NCT03152071	Lung Cancer Postoperative P... Blood Loss Inflammatory Re...	Robot assited t... Video assited t...	18 Years -	Universitair Ziekenhuis Brussel

Spots Global Cancer Trial Database for thoracoscopic surgery