University Hospital of Bern, Inselspital
Bern, 3013, Switzerland
Location status: Recruiting
Recruiting
NCT Number: NCT04670523
Early Postoperative Day 0 Chest Tube Removal After Thoracoscopic Minor Surgeries
The safe conditions for early chest tube removal have been progressively questioned and redefined around reliable digital air flow criteria and extension of liquid threshold accepted. Nevertheless, in current practice, the chest tube remains in restricting early mobilization and optimal compliance with ERAS programme, during the first crucial 24 h after surgery. Thus, to go further, the investigators decide to assess in this study the safety of POD 0 chest tube removal after minor thoracic operations in patients in health condition tolerating operation and anesthesia.
Recruiting
Interested in participating?
Request InfoKey information
Conditions
Age range
18 year–99 year
Sex eligibility
All sexes
Study type
Interventional
Phase
Not applicable
Primary location
About this study
Chest tube management is a key element of postoperative care after thoracic surgeries for different indications. During the last decade, minimally invasive surgery and enhanced recovery after surgery (ERAS) programmes have radically changed the equation of recovery, contributing to reduce postoperative morbidity and enhance quality of life, but the chest tube remains its Achilles heel, still providing postoperative pain and impairing pulmonary function. In this view, early chest tube removal has been widely promoted not only for its economic benefits on length of stay but also for improving quality of life and potentially reducing postoperative complications. In parallel, the change from traditional chest drainage devices to electronic devices has also enabled a more accurate air leak measurement with reduction of interobserver variability, decreased chest drainage duration and shortened LOS. The safe conditions for early chest tube removal have been progressively questioned and redefined around reliable digital air flow criteria and extension of liquid threshold accepted. Nevertheless, in current practice, the chest tube remains in restricting early mobilization and optimal compliance with ERAS programme, during the first crucial 24 h after surgery. Thus, to go further, the investigators decide to assess in this study the safety of POD 0 chest tube removal after minor thoracic operations in patients in health condition tolerating operation and anesthesia.
Who can participate
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
- Thoracoscopic extra-anatomical lung resection (surgical lung biopsy)
- Thoracoscopic pleural biopsy
- Signed consent
- Age of majority
Exclusion criteria
- Anatomical resection
- Empyema
- Pleural effusion
- Pleurodesis
- Vulnerable persons (Pregnant women, Children and adolescents)
Treatment and study plan
Early postoperative day 0 (POD 0) chest tube removal.
ProcedureChest tube removal is a standard bedside intervention after lung resections. Its time point is normally defined according a traditional standard airleak threshold. Traditionally, in our department this threshold will be respected not earlier than 1 day after the operation. The patients of the study group are getting their chest tube removed according to our current airleak protocol (Flow <20 mL/ min on digital suction device) but already in the operating room after wound closure (POD 0). If airleak is persisting than chest tube removal will be performed according to the traditional protocol not earlier than on postoperative day 1 (POD 1).
Chest tube removal according to traditional standard protocol not earlier than on postoperative day 1 (POD 1).
ProcedureChest tube removal according to traditional standard protocol not earlier than on postoperative day 1 (POD 1).
Primary outcomes
-
1. Pneumothorax requiring chest tube reinsertion
Time frame: Pneumothorax 2 hours after chest tube removal between postoperative day 0 and 30 (POD 0 - 30)
Number of patients with pneumothorax requiring chest tube reinsertion after removal of initial chest tube
-
2. Pleural effusion requiring thoracocentesis
Time frame: Pleural effusion 2 hours after chest tube removal between POD 0 and 30
Number of patients with pleural effusion requiring thoracocentesis after removal of first chest tube
-
3. Prolonged air leak > 5 days
Time frame: Chest tube removal between POD 6 and 30
Number of patients with persisting air leak longer than 5 days
-
4. Re-admission or reoperation due to pleural complication
Time frame: Up to 1 month after first operation
Number of patients re-admitted to a hospital after first hospitalization
Secondary outcomes
-
1. Cardiopulmonary complications (Pneumonia, Atrial fibrillation, ARDS)
Time frame: Up to 1 month after initial operation
Number of patients with cardiopulmonary complications (Pneumonia, Atrial fibrillation, ARDS) after operation
-
2. Re-operation
Time frame: Up to 1 month after initial operation
Number of patients requiring a re-operation after initial operation
-
3. Length of drainage (days)
Time frame: Up to 1 month after initial operation
Average of time with chest tube in site
-
4. Length of stay (days)
Time frame: Up to 1 month after initial operation
Average of time in hospital
Study contacts
Contact information is provided by the study sponsor or research team.
Sponsors and collaborators
Lead sponsor
Insel Gruppe AG, University Hospital Bern
Other
Registry information
Official study title
Early Postoperative Day 0 Chest Tube Removal After Thoracoscopic Minor Surgeries. A Randomized Controlled Clinical Trial.
Acronym: CTremoval
Important dates
- Study start
- 2023
- Primary completion
- 2027
- Study completion
- 2027
- First posted
- Dec 17, 2020
- Registry last updated
- Apr 29, 2026
OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.
View the official ClinicalTrials.gov record (opens in a new tab)This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.