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Morphologic Study of the Intersegmental Plane After Fully Thoracoscopic Segmentectomy

2017年7月21日 更新者:Institut Mutualiste Montsouris
The objective of this study is to determine whether stapling adversely affects the pulmonary parenchyma and the vascularisation of the adjacent segments. The aim of our work is to explore by thoracic densitometry with contrast the spared segments after stapling of the intersegmental plan following a thoracoscopic segmentectomy, 3 or 6 months post-surgery. the investigator will assess venous drainage and the arterial vascularisation of the remaining segments, possible modifications of the adjacent parenchyma and whether there is a defect of pleuro-pulmonary adhesion (residual pneumothorax).

研究概览

详细说明

Scheduled anatomical segmentectomies are increasingly popular, due to the development of minimally invasive techniques, the increased incidence of early-stage tumours, and the possibility of caring for patients with compromised health and/or limited respiratory function without compromising the oncological outcome, compared to current alternatives such as stereotactic ablative radiotherapy (1).

One of the challenges in the development of the thoracoscopic segmentectomy technique we have published (2-5) is the orientation (6-7) and the division of the intersegmental plane, by contrast to segmentectomy by thoracotomy where this is helped by palpation and the manual traction which can be used on the segment, along the intersegmental vein. The most commonly used technique to separate two adjacent segments remains stapling, despite its high cost and sometimes giving a less anatomical section, with a risk to encroach on the intersegmental vein. Moreover, there can be a partial plicator of the spared segment(s) which could in theory make them less functional.

We have however shown that the postoperative morbidity and mortality rates were much lower than that of patients who had a thoracotomy, dropping from 42% for thoracotomies to 16% for thoracoscopies, the surgical approach being an independent predictive factor for postoperative complications (8).

研究类型

介入性

注册 (预期的)

40

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Paris、法国、75014
        • 招聘中
        • Institut Mutualiste Montsouris
        • 接触:
          • Isabelle Sauret

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

有资格学习的性别

全部

描述

Inclusion Criteria:

  • Enrolment in the study will be offered to all patients having undergone a programmed scheduled video-assisted thoracoscopic segmentectomy, whatever the aetiology.
  • Men or women aged 18 years or greater
  • Absence of severe hepatic insufficiency
  • signed and dated informed consent
  • candidate for segmentectomy
  • Registration in a national healthcare system.
  • Women of child-bearing age using effective oral or barrier contraception

Exclusion Criteria:

  • Proven intolerance to iodinated contrast agents
  • Know allergy or non-controlled asthma - pregnancy
  • Severe hepatic insufficiency (creatinine clearance < 30ml/min, by Cockroft's method)
  • Pregnant or breastfeeding women
  • Patients under trusteeship or curators
  • Diabetic patients or patients receiving oral antidiabetic medication

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:其他
  • 分配:不适用
  • 介入模型:单组作业
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
其他:radiological evaluation
to explore by thoracic densitometry with contrast the spared segments after stapling of the intersegmental plan following a thoracoscopic segmentectomy
injected CT scan at 3 or 6 months after segmentectomy VATS

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
The measure of the remaining segments after stapling the intersegmental plane by injected CT scan
大体时间:3 or 6 months after surgery

The aim of investigators work is to explore by thoracic densitometry with contrast the spared segments after stapling of the intersegmental plan following a thoracoscopic segmentectomy, from 3 to 6 months post-surgery. The investigators will assess venous drainage and the arterial vascularisation of the remaining segments, possible modifications of the adjacent parenchyma and whether there is a defect of pleuro-pulmonary adhesion (residual pneumothorax).

The radiological evaluation criteria will be:

  • Presence and quantification of a defect in pulmonary expansion (residual pneumothorax)
  • Abnormal venous and arterial vascularisation of the remaining segments
  • Defect of the pulmonary parenchyma in contact with the staples line (atelectasis, vascularisation defect)
3 or 6 months after surgery

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2017年3月31日

初级完成 (预期的)

2018年2月20日

研究完成 (预期的)

2018年8月30日

研究注册日期

首次提交

2017年6月19日

首先提交符合 QC 标准的

2017年7月21日

首次发布 (实际的)

2017年7月24日

研究记录更新

最后更新发布 (实际的)

2017年7月24日

上次提交的符合 QC 标准的更新

2017年7月21日

最后验证

2017年7月1日

更多信息

与本研究相关的术语

其他研究编号

  • THO-2016-01

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

未定

药物和器械信息、研究文件

研究美国 FDA 监管的药品

研究美国 FDA 监管的设备产品

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