The investigators conducted a muti-centres randomized controlled clinical trial to explore the effect of preservation of inferior pulmonary ligment compared with dissection.
Dissection of the inferior pulmonary ligament (IPL) has been a common practice in upper lobectomy to facilitate the expansion of the remaining lung, reduce dead space after resection, and minimize complications such as pleural effusion and pulmonary infection. However, studies have found that IPL dissection does not improve patient outcomes. On the contrary, releasing the restriction may lead to excessive movement of the remaining lobes, resulting in significant changes in bronchial angles and lung volume, which can worsen pulmonary function and increase postoperative symptoms. Most existing studies are retrospective, providing relatively low-level evidence. Moreover, previous research has primarily focused on radiographic outcomes and pulmonary function tests results, while the effect on patients' symptom burden has been largely overlooked. From the patient's perspective, symptom burden might be more significant, reflecting the clinical value of changes in radiographic and functional indices. In this study, the investigators applied patient-reported outcomes to measure symptoms. Combined with pulmonary function results and radiological outcomes, the investigators compared the clinical value of preserving versus dissecting the IPL in upper lobectomy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
200
IPL was preserved during surgery
General Hospital of Southern Theater Command of the Chinese People's Liberation Army
Guangzhou, Guangdong, China
Guangdong Provincial People's Hospital
Guangzhou, Guangdong, China
The Affiliated Panyu Central Hospital of Guangzhou Medical University
Guangzhou, Guangdong, China
The First Affiliated Hospital of Guangdong Pharmaceutical University
Guangzhou, Guangdong, China
Cough score postoperation
The investigators used PSA-LUNG questionnaire to assess patients symptom burden after surgery. Changing of cough score during 1 month postoperation was chosen as the primary outcome.
Time frame: up to 3 months
Other Symptom burden postoperation PSA-LUNG questionnaire
Using PSA-LUNG questionnaire, the investigators assessed shortness of breath, pain, sleeplessness, annoy, and fatigue after surgery.
Time frame: up to 3 months
Radiological outcome
Changing of bronchial angels measured with chest x-ray examination or chest CT.
Time frame: Day 1 after surgery; 1 month after discharge; 3 months after discharge
Radiological outcome
dead spece rate measured with chest x-ray examination or chest CT.
Time frame: Day 1 after surgery; 1 month after discharge; 3 months after discharge
Radiological outcome
degree of lung collapse measured with chest x-ray examination or chest CT.
Time frame: Day 1 after surgery; 1 month after discharge; 3 months after discharge
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Shantou University Medical College
Shantou, Guangdong, China