Effect of Partial Rib Resection On the Control of Post-thoracotomy Pain

Study Overview
=================
Brief Summary
-----------------
The aim of this study is to evaluate the effect of partial rib resection in reducing acute post-thoracotomy pain

Detailed Description
-----------------
It is known that severe post thoracotomy pain can be reduced by half with some strategies to prevent pain development. It was thought that partial rib resection would reduce intercostal tension and prevent an uncontrolled fracture. Thus, it is argued that post thoracotomy pain can be reduced. Partial rib resection is applied in clinical practice in selected patient groups. However, we could not find a clinical study on this subject in the English literature. The aim of this study is to determine whether partial rib resection has an effect on the control of thoracotomy pain. Before the thoracotomy incision, simple randomization will be performed by flipping a coin. Routine thoracotomy incision will be performed in the control group. In the intervention group, approximately 1 cm segment of the 6th rib will be excised with a rib scissors before the thorax retractor was placed. Pericostal suture technique will be used in both groups at thoracotomy closure. Demographic information of the cases, preoperative respiratory function parameters, body mass index, Visual Analogue Scale scores, complications and analgesic doses will be recorded in the Case Report Form regularly.

Official Title
-----------------
Effect of Partial Rib Resection On the Control of Post-thoracotomy Pain: A Randomized Prospective Study

Conditions
-----------------
Pain, Postoperative, Iatrogenic Injury, Post-thoracotomy Pain Syndrome

Intervention / Treatment
-----------------
* Procedure: Partial rib resection


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Participants who underwent thoracotomy in our clinic in 2019-2020 Participants signing an informed consent form Exclusion Criteria: Thoracic wall tumor Invasion of the thoracic wall by extrathoracic malignancy Pleural pathology History of previous rib fracture History of previous thoracotomy History of thoracic radiotherapy Emergency surgery Simultaneous incisions other than thoracotomy

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: Clinical data of intervention group and control groups will be compared
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control Group<br>Includes patients undergoing routine thoracotomy | |
| Experimental: Intervention Group<br>The group that will undergo 1 cm partial rib resection during thoracotomy. | Procedure: Partial rib resection<br>* 1 cm partial rib resection during thoracotomy opening<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative visual analog scale scores | Min:1, Max:10 points, Higher scores mean worse outcome | 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Iatrogenic rib fractures | Yes or no | During operation | 
| Administered analgesic doses | Milligram | Up to 4 weeks | 
| Duration of drainage | Days | Up to 4 weeks | 
| Length of hospital stay | Days | Up to 4 weeks | 
| Number of participants with postoperative bronchopulmonary complications | Yes or no | Up to 4 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Post thoracotomy pain, Iatrogenic rib fracture, Thoracotomy, Partial rib resection