- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06015399
Methods of Establishing Intersegmental Plane in Segmentectomy
August 24, 2023 updated by: Liu Wenliang, Second Xiangya Hospital of Central South University
Methods of Establishing Intersegmental Plane in Segmentectomy: a Prospective Randomized Controlled Study
The aim of this study is to perform a prospective, single-center, randomized controlled study to explore whether closed insufflation technique is not inferior to dilatation and collapse technique in segmentectomy, and to provide a new option for establishing intersegmental plane in segmentectomy.
Study Overview
Status
Not yet recruiting
Conditions
Detailed Description
This is a single-center, prospective, randomized controlled study.
A total of 200 subjects undergoing segmentectomy are scheduled to be enrolled within 1 year, and the subjects are randomly divided into closed insufflation group or dilatation and collapse group using a random number table generated by the computer, with 100 cases in each group.
Intersegmental plane resolution grading, perioperative complications, operative time, intraoperative blood loss, postoperative hospitay stay, and pulmonary function 3 months and 1 year after surgery will be extracted and compared between the groups.
Study Type
Interventional
Enrollment (Estimated)
200
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Yan Hu, M.D., Ph.D.
- Phone Number: +8685296122
- Email: yanhu@csu.edu.cn
Study Locations
-
-
Hunan
-
Changsha, Hunan, China, 410011
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, China
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Patients voluntarily join and sign a written informed consent;
- The age of the subjects is 18-75 years old, regardless of gender;
- The ECOG PS was 0 or 1;
- Three-dimensional visualization was performed before surgery, and the surgeon judged that the tumor could be completely removed by segmentectomy, and surgical margin was expected to be greater than 2cm or the maximum diameter of the nodule;
- Thin-slice CT suggests any of the following: ① The diameter of pulmonary nodules is 2-3cm and the consolidation-tumor ratio (CTR) is less than 0.25; ② Pulmonary nodule diameter ≤2cm and 0.25 < CTR < 0.5; ③ Non-peripheral pulmonary nodule diameter ≤2cm and CTR≤0.25;
- cN0 and no distant metastasis;
- Intraoperative freezing examination or postoperative paraffin examination suggest early lung adenocarcinoma;
- Intraoperative freezing disease of station 12 lymph nodes showed no cancer metastasis;
- Preoperative anesthesia risk assessment: American Society of Anesthesiologists (ASA) Level I-III;
- Has no history of lung resection;
- Has not received anti-tumor therapy such as radiotherapy, chemotherapy, targeted therapy and immunotherapy.
Exclusion Criteria:
- The subject did not understand the study protocol, did not cooperate or refused to sign the informed consent;
- The subject has a history of malignant tumor or has previously received anti-tumor therapy;
- 3D visualization was not received before surgery;
- The surgeon judged that segmentectomy could not ensure complete resection of the tumor;
- has a history of lung resection, or chest trauma or surgery on the affected side of chest cavity;
- Extensive intraoperative dense thoracic adhesion;
- Conversion to thoracotomy;
- Intraoperative frozen examination of intrapulmonary lymph nodes indicated cancer metastasis;
- Pulmonary nodules are located in the right middle lung;
- Suffered from chronic bronchitis, emphysema, asthma and other chronic lung diseases;
- Other conditions unsuitable for inclusion in this study deemed by the researcher.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Closed insufflation technique group
Closed insufflation technique is characterized by ligation in the proximal portion of targeted bronchus and gas injection in the distal portion.
Closed insufflation technique group includes patients undergoing segmentectomy using closed insufflation technique.
|
After the identification the targeted segmental bronchus during the operation,ligating the proximal end of the targeted bronchus.
Put the vessel separation forceps in the distal bronchial space to avoid the accidental damage of the vessels.
Use a 50ml syringe to inject air into the distal bronchus (about 100ml is expected) until the intersegmental plane is satisfactory.
Divide the target bronchus using the cutting and closing device.
|
Active Comparator: Dilatation and collapse technique
Dilatation and collapse technique is characterized by pure oxygen dilatation and subsequent collapse after the division of targeted bronchus.
Dilatation and collapse technique group includes patients undergoing segmentectomy using Dilatation and collapse technique.
|
Divide the target bronchus using the cutting and closing device.
Ask the anesthesiologist to inflate the lung completely from pure oxygen to the affected side and then change to single lung ventilation.
Wait for the intersegmental plane to appear(usually about 15 minutes).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Intersegmental plane clarity grading
Time Frame: intraoperatively
|
Intersegmental plane clarity will be graded as followed: G1: partial collapse of targeted parenchymal tissue, G2: partial dilatation of non-targeted adjacent tissue, G3: dilatation of targeted tissue and unclearness of intersegmental plane, G4: entire dilatation of targeted tissue and clearness of intersegmental plane.
|
intraoperatively
|
Surgical complications
Time Frame: Up to 3 months
|
Surgical complications will be assessed according to the Society of Thoracic Surgeons database criteria.
|
Up to 3 months
|
Operative time required for segmentectomy
Time Frame: From the dissection of segmental structures to finish of segementectomy
|
Operative time required for segmentectomy will be measured as the total minutes from initiation to completion of segmentectomy.
|
From the dissection of segmental structures to finish of segementectomy
|
Pulmonary function 3 months and 1 year after surgery
Time Frame: Up to 1 year
|
Pulmonary function includes ventilation and diffusion function.
Pulmonary function will be measured at two time points including 3 months and 1 year after surgery.
|
Up to 1 year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Intraoperative blood loss
Time Frame: Intraoperatively
|
Intraoperative blood loss will be measured as the total volume of blood loss during the operation.
|
Intraoperatively
|
Postoperative hospital stay
Time Frame: Up to 2 weeks
|
Postoperative hospital stay will be measured as the number of days between surgery and discharge.
|
Up to 2 weeks
|
Days of chest tube placement
Time Frame: Up to 2 weeks
|
Days of chest tube placement will be measured as the number of days between surgery and chest tube pull-out.
|
Up to 2 weeks
|
Safety margin
Time Frame: Up to 1 week
|
Minimum distance between nodule and every margin can be measured preoperatively by 3D reconstruction tool and intraoperatively by ruler after the targetd segment has been resected.
|
Up to 1 week
|
Volume of targeted parenchymal tissue
Time Frame: Up to 3 days
|
Volume of targeted parenchymal tissue will be calculated by 3D reconstruction tool.
|
Up to 3 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Estimated)
September 1, 2023
Primary Completion (Estimated)
September 1, 2025
Study Completion (Estimated)
March 1, 2026
Study Registration Dates
First Submitted
August 20, 2023
First Submitted That Met QC Criteria
August 24, 2023
First Posted (Actual)
August 29, 2023
Study Record Updates
Last Update Posted (Actual)
August 29, 2023
Last Update Submitted That Met QC Criteria
August 24, 2023
Last Verified
August 1, 2023
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- LYF2023098
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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