Effect of Dissecting of The Inferior Pulmonary Ligament on Postoperative Pulmonary Reexpansion and Recurrence

Study Overview
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Brief Summary
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This subject analysis of the influence of the dissociating inferior pulmonary ligament on pulmonary reexpansion and recurrence in the treatment of primary spontaneous pneumothorax by video assisted thoracic surgery. All patients are randomly divided into two groups: group A and group B. Wedge resection(WR) will be performed for all patients. Investigators dissect the inferior pulmonary ligament(DIPL) for group A. Investigators do not dissect the inferior pulmonary ligament for group B. The pulmonary reexpansion and recurrence rate are observed between the two groups.

Detailed Description
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Wedge resection of the lung is usually used in the treatment of primary spontaneous pneumothorax. And the pleural treatment also might be used. But part of secondary pneumothorax patients who had undergone surgical, the bullae can be found especially in the apical of lung, even if the pleural have been treated in some way.This subject provides a new way of thinking and method to solve the problem of recurrent spontaneous pneumothorax.

Official Title
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Effect of Dissecting of The Inferior Pulmonary Ligament on Postoperative Pulmonary Reexpansion and Recurrence After Operation by Video-assisted Thoracic Surgery in the Treatment of Primary Spontaneous Pneumothorax(PSP)

Conditions
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Pneumothorax

Intervention / Treatment
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* Procedure: DIPL
* Procedure: WR
* Procedure: thoracoscopic surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The patients diagnosis pneumothorax with chest radiograph or computed tomography (CT) The clinical and final pathological diagnosis for patient is PSP. The patients with stable vital signs, no contraindication for operation and no communication barriers. The patients,after informed of test content, significance and risk, who voluntarily enroll and sign informed consent. Exclusion Criteria: The patients who refuse to do a video assisted thoracic surgery. The patients with pneumothorax with specific causes such as pulmonary hamartoangiomyomatosis, catamenial pneumothorax, and pneumothorax secondary to chronic obstructive pulmonary disease. The patients who were older than 50 years The patients with familial history of pneumothorax. The patients with mental disorders, low Intelligence Quotient, can not objectively reflect the indicators of observation. The patients who refuse to follow-up.

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 50 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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: WR AND DIPL<br>patients undergo wedge resection and dissection the inferior pulmonary ligament by thoracoscopic surgery or video assisted thoracoscopic surgery | Procedure: DIPL<br>* dissection of the inferior pulmonary ligament<br>Procedure: WR<br>* wedge resection of the lung bleb<br>Procedure: thoracoscopic surgery<br>* surgery performed by video assisted thoracoscopy<br>|
| Active Comparator: WR<br>patients undergo wedge resection by thoracoscopic surgery or video assisted thoracoscopic surgery without dissection the inferior pulmonary ligament | Procedure: WR<br>* wedge resection of the lung bleb<br>Procedure: thoracoscopic surgery<br>* surgery performed by video assisted thoracoscopy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| recurrence rate | the 3- year recurrence rate of pneumothorax after surgery. | 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pulmonary reexpansion rate | the proportion of pulmonary reexpansion on the first and fourth day after operation. | 1 day and 4 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Prime Spontaneous Pneumothorax, recurrence