Chest Tube After a Video-assisted Thoracoscopic Surgery Pulmonary Wedge Resection

Study Overview
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Brief Summary
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After performing VATS pulmonary wedge resections, a chest tube is routinely left in the pleural cavity to drain possible air leaks and fluid accumulations. Chest tubes after VATS pulmonary wedge resections are left in place a minimum of 1 day. However, this practice has no scientific foundations. The investigators believe it is possible to avoid the placement of a chest tube after this procedure in a great amount of patients. This is a randomized controlled clinical trial with analysis blinding in which the investigators want to compare the outcomes between installing a chest tube or not after VATS pulmonary wedge resections. The investigators will include consecutively patients with interstitial lung disease or indeterminate pulmonary nodules undergoing this procedure, at the participating institutions. The investigators calculated a sample size of 50 subjects in each group using pneumothorax < 10% data from Luckraz et al and to determine a difference of hospital stay of 2 versus 1 day; DS(1.5), power = 0.9 and alpha = 0.05.

Official Title
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The NoTube Study: Evaluation of the Necessity of a Chest Tube After a Video-assisted Thoracoscopic Surgery Pulmonary Wedge Resection.

Conditions
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Lung Diseases, Interstitial, Pulmonary Nodule, Solitary

Intervention / Treatment
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* Procedure: Do not leave a chest tube in the pleural cavity.
* Procedure: Do leave a chest tube in the pleural cavity.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing video-assisted thoracoscopic surgery pulmonary wedge resections at the participating institutions. No evidence of air leak at the end of the surgical procedure. No active bleeding at the end of the surgical procedure. Exclusion Criteria: Pleural effusion previous to the procedure requiring drainage after it. Bullous or emphysematous changes in lung parenchyma. Patients going to positive pressure in the airways after the procedure.

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: No chest tube<br>No chest tube left in the pleural cavity at the end of a VATS pulmonary wedge resection. | Procedure: Do not leave a chest tube in the pleural cavity.<br>* At the end of a VATS wedge resection, an air leak proof will take place and if no air leak is noted, the surgical incisions for thoracoscopy ports will be closed without leaving a chest tube inserted in the pleural cavity of the patient.<br>|
| Active Comparator: Chest tube<br>Chest tube left in the pleural cavity at the end of a VATS pulmonary wedge resection. | Procedure: Do leave a chest tube in the pleural cavity.<br>* At the end of a VATS wedge resection, a chest tube will be inserted in the pleural cavity of the patient through the inferior surgical incision for thoracoscopy port; the rest of the incisions will be closed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pneumothorax >10% / Hemothorax |  | 1 hour and 1-5 days postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain (Visual analogue scale) |  | At days 1-5 of hospitalization and at 1 month | 
| Surgical procedure duration |  | At the end of surgery | 
| Hospital stay |  | At patient discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chest Tubes, Thoracic Surgery, Video-Assisted, Lung Diseases, Interstitial, Pulmonary Nodule, Solitary