Randomized Study on Effects of Uniportal VATS Versus Triportal VATS
Randomized Study on Effects of Uniportal VATS Versus Triportal VATS for the Treatment of Stage I-II NSCLC
For the treatment of stage I-II NSCLC, two mini-invasive techniques are mostly utilized: uni-portal and three-portal VATS. In the uniportal approach, the injury on a single intercostal space could determine a lower level of pain than the three-portal approach, allowing a better postoperative course. Few studies in Literature compare these techniques, and most of them are retrospective.
The main purpose of this randomized study is to compare uni-portal VATS with three-portal VATS, in terms of postoperative pain.
Secondary objectives of the study are valutations of:
- respiratory and functional capacity between the two groups
- operative time
- number of resected lymphnodes
- intra and postoperative complications, such as conversions to open surgery, amount of bleeding, prolonged air leaks, surgical site infections, pulmonary complications.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Randomized cohort clinical trial, prospectic, monocentric. Procedure of randomization: the day before the operation, with the "Random Allocation Rule" technique
Arm 1: pulmonary lobectomy and lymphoadenectomy with uni-portal VATS approach
Arm 2: pulmonary lobectomy and lymphoadenectomy with three-portal VATS approach
Misurations Total analgesic consumption, normalized to morphine milligrams, recorded in the 7 days following the operation.
The choice of cumulative analgesic consumption as parameter of primary outcome is because pain valuation with VAS is significantly affected by individual variability.
Secondary outcomes: measure of postoperative pain with NRS at 2,6,12,24 hours and at 2,3,4,5,30 days from sugery. A pain score will be assigned to each patient after the total amount of NRS.
Respiratory function will be valuated with spirometry after 7 and 30 days from surgery, and compared with pre-operative tests.
All intraoperative parameters will be compared between the two groups: operative time (skin to skin), proportion of conversions to open surgery, number of resected lymphnodes, amount of bleeding.
Postoperative complications will be analyzed: rate of prolonged air leaks, surgical site infections, cardiac rythhm disfunctions, pulmonary complications, post-thoracotomy syndrome, as well as lenght of stay at the hospital.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
Mi
-
Milan, Mi, Italy, 20100
- Thoracic Surgery Unit - Fondazione IRCCS Ca' Granda Policlinico
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients with cT1-2N0-1M0 NSCLC, maximum diameter 5cm
- ASA (American Society of Anestesiology) score 1-2-3
Exclusion Criteria:
- N2-N3 disease
- Induction chemotherapy
- Thoracic wall infiltration
- Previous thoracic surgery
- Important pleural adhesions
- Severe COPD, asthma, interstitial lung disease - Liver, kidney or cardiac failure
- Clotting disorders
- Analgesic allergy
- Sublobar resection, sleeve lobectomy, pneumonectomy
- Chronic analgesic, oppioids or cortisonic use
- Absence of informed consent
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Uni-portal VATS
VATS uni-portal lobectomy and lymphoadenectomy
|
VATS uni-portal lobectomy and lymphoadenectomy
|
|
Three-portal VATS
VATS three-portal lobectomy and lymphoadenectomy
|
VATS three-portal lobectomy and lymphoadenectomy, Copenhagen approach
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Measurement of postoperative pain after uni-portal and three-portal VATS
Time Frame: 7 days
|
Total analgesic consumption, normalized to morphine milligrams, recorded in the 7 days following the operation.
|
7 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Measure of postoperative pain with NRS at 2,6,12,24 hours and at 2,3,4,5,30 days from sugery.
Time Frame: 30 days
|
A pain score will be assigned to each patient after the total amount of NRS
|
30 days
|
|
Valuation of respiratory function
Time Frame: 30 days
|
Spirometry after 7 and 30 days from surgery, compared with pre-operative tests
|
30 days
|
|
Intraoperative parameters
Time Frame: 1 day
|
Operative time (skin to skin, minutes)
|
1 day
|
|
Intraoperative bleeding
Time Frame: 1 day
|
Amount of bleeding
|
1 day
|
|
Postoperative air leakage
Time Frame: 15 days
|
Rate of prolonged air leaks
|
15 days
|
|
Postoperative complications
Time Frame: 1 month
|
Cardiac rythhm disfunctions
|
1 month
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Davide Tosi, Fondazione Ca' Granda IRCCS Policlinico Milan
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- 3564
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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