Clinical trial · Interventional
Chest dRain rEmoval intrAoperatively afTer thoracOscopic Wedge Resection
Efficacy of Avoiding Chest Drain After Video-assisted Thoracoscopic Surgery Wedge Resection
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Chest drain is used routinely after lung surgery. Despite preliminary studies demonstrate the feasibility and safety of intraoperative chest drain removal, these are either retrospective or mainly concerning benign disease. Hypothesis: Participants treated without post-operative chest tube after thoracoscopic wedge resection have less pain, reduced opioid usage without increasing postoperative complications than participants treated with standard post-operative chest tube, and could possibly be discharged earlier.
Conditions
Conditions (7)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Enhanced Recovery After Surgery | — | UNRESOLVED | — |
| Fast-track Surgery | — | UNRESOLVED | — |
| Lung Neoplasms | Lung Neoplasm | ONTOLOGY_EXACT | 0.98 |
| Lung Surgery | — | UNRESOLVED | — |
| Opioid Use | — | UNRESOLVED | — |
| Pain | — | UNRESOLVED | — |
| Remission | — | UNRESOLVED | — |
Interventions
Interventions (3)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Intraoperative air leak test | Procedure | — | UNRESOLVED |
| Intraoperative chest drain removal | Procedure | — | UNRESOLVED |
| Standard chest drain placement | Procedure | — | UNRESOLVED |
Design
Arms and outcomes
Arms (2)
- type
- EXPERIMENTAL
- label
- Drain-free group
- description
- Participants undergoing video-assisted thoracoscopic wedge resection with a positive intraoperative sealing test are treated with intraoperative chest tube removal.
- interventionNames
- Procedure: Intraoperative air leak test
- Procedure: Intraoperative chest drain removal
- type
- ACTIVE_COMPARATOR
- label
- Chest drain group
- description
- Participants undergoing video-assisted thoracoscopic wedge resection with a positive intraoperative sealing test are treated with a standard postoperative chest tube.
- interventionNames
- Procedure: Intraoperative air leak test
- Procedure: Standard chest drain placement
Primary outcomes (2)
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
Inclusion Criteria: * Age ≥18 years. * Patients referred for elective three port video-assisted thoracoscopic surgery wedge resection of the lung for suspected or confirmed malignant nodules. * first second forced expiratory volume ≥60% of expected. * No increased bleeding risk (e.g. preoperative international normalized ratio \>2, overdue discontinuation of anticoagulants according to guidelines by the Danish Society for Thrombosis and Haemostasis, known coagulopathy). * Not scheduled for frozen section pathology of wedge resection and subsequent lobectomy. * Able and willing to give informed consent. Exclusion Criteria: * Increased risk of post-operative air leak assessed perioperatively by the surgeon (e.g. severe adhesions, bullous/emphysematous lung tissue, defects of the visceral pleura due to iatrogenic or other reasons, suturing in the lung tissue, deep lung resection). * Increased risk of post-operative bleeding assessed perioperatively by the surgeon (e.g. intraoperative bleeding or oozing). * Air leak during intraoperative air leak test.
References
Publications (28)
- RESULTCerfolio RJ, Bryant AS. The management of chest tubes after pulmonary resection. Thorac Surg Clin. 2010 Aug;20(3):399-405. doi: 10.1016/j.thorsurg.2010.04.001. PMID 20619231
- RESULTLuckraz H, Rammohan KS, Phillips M, Abel R, Karthikeyan S, Kulatilake NE, O'Keefe PA. Is an intercostal chest drain necessary after video-assisted thoracoscopic (VATS) lung biopsy? Ann Thorac Surg. 2007 Jul;84(1):237-9. doi: 10.1016/j.athoracsur.2007.03.007. PMID 17588421
- RESULTHolbek BL, Horsleben Petersen R, Kehlet H, Hansen HJ. Fast-track video-assisted thoracoscopic surgery: future challenges. Scand Cardiovasc J. 2016;50(2):78-82. doi: 10.3109/14017431.2015.1114665. Epub 2015 Dec 1. PMID 26514281
- RESULTRefai M, Brunelli A, Salati M, Xiume F, Pompili C, Sabbatini A. The impact of chest tube removal on pain and pulmonary function after pulmonary resection. Eur J Cardiothorac Surg. 2012 Apr;41(4):820-2; discussion 823. doi: 10.1093/ejcts/ezr126. Epub 2011 Dec 21. PMID 22219425
- RESULTMao M, Hughes R, Papadimos TJ, Stawicki SP. Complications of chest tubes: a focused clinical synopsis. Curr Opin Pulm Med. 2015 Jul;21(4):376-86. doi: 10.1097/MCP.0000000000000169. PMID 26016583
- RESULTBardell T, Petsikas D. What keeps postpulmonary resection patients in hospital? Can Respir J. 2003 Mar;10(2):86-9. doi: 10.1155/2003/610570. PMID 12693389
- RESULTWildgaard K, Petersen RH, Hansen HJ, Moller-Sorensen H, Ringsted TK, Kehlet H. Multimodal analgesic treatment in video-assisted thoracic surgery lobectomy using an intraoperative intercostal catheter. Eur J Cardiothorac Surg. 2012 May;41(5):1072-7. doi: 10.1093/ejcts/ezr151. Epub 2011 Dec 21. PMID 22219442
- Watanabe A, Watanabe T, Ohsawa H, Mawatari T, Ichimiya Y, Takahashi N, Sato H, Abe T. Avoiding chest tube placement after video-assisted thoracoscopic wedge resection of the lung. Eur J Cardiothorac Surg. 2004 May;25(5):872-6. doi: 10.1016/j.ejcts.2004.01.041.