This study evaluates the viability and safety of two-lumen catheterization versus chest tube placement in patients with lung wedge resection. Half of participants will receive routine chest tube placement, 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\~40% cases, and some of them need re-intervention. Hence, the investigators designed a intra-operative two-lumen catheterization for remedial gas-remove. Therefore, this study evaluates the viability and safety of two-lumen catheterization versus chest tube placement in patients with lung wedge resection.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
96
VATS with chest tube placement
VATS with two-lumen catheterization long the midclavicular line, second intercostal space
central venous catheter(two-lumen 7-Fr-20cm)
Guangdong General Hospital
Guangzhou, Guangdong, China
RECRUITINGPostoperative adverse event incidence rate
To evaluate the incidence rate of pneumothorax (a pneumothorax greater than 2.0 cm on X-ray) or pleural effusion (\>800ml) in both groups.
Time frame: 1 months
Length of post-operative hospital stay
To evaluate the length of post-operative hospital stay
Time frame: 1 week
Rate of post-operative related complications
To evaluate the rate of post-operative related complications within 7 days of surgery
Time frame: 1 week
Postoperative pneumoderm incidence rate
To evaluate the postoperative pneumoderm incidence rate in both groups.
Time frame: 3 days
The time of post-operative extubation
To evaluate the time of duration of chest tube or catheterization.
Time frame: 1 week
Postoperative pulmonary function recovery
To evaluate the postoperative cardiopulmonary function recovery via 6-minute walk test in both groups.
Time frame: 1 week
Postoperative pain score
To evaluate the pain score via NRS pain scale first day after surgery.
Time frame: 1 day
Postoperative wound satisfaction
To evaluate the post-operative wound healing condition .
Time frame: 1 month
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