Intra-operative Air Leak Management After Minimally Invasive Lung Segmental Resection

Trial Title: Intra-operative Air Leak Management After Minimally Invasive Lung Segmental Resection

NCT ID: NCT06544200

Condition: Lung Cancer Stage I
Lung; Node
Air Leak From Lung

Conditions: Keywords:
thoracoscopic surgery
Segmentectomy
Air Leak
Hydrogel Matrix

Study type: Interventional

Study phase: N/A

Overall status: Recruiting

Study design:

Allocation: Randomized

Intervention model: Parallel Assignment

Primary purpose: Treatment

Masking: None (Open Label)

Intervention:

Intervention type: Device
Intervention name: Polymeric Hydrogel Matrix
Description: application of Polymeric Hydrogel Matrix along the suture line at the completion of lung resection
Arm group label: Polymeric Hydrogel Matrix

Summary: In patients undergoing minimally invasive thoracoscopic surgery (video-assisted thoracoscopic surgery, or VATS), a still unsolved issue is represented by intraoperative alveolar air leaks (IOAALs), which if prolonged beyond the fifth postoperative day can lead to higher risk of complications and higher medical costs. The polymeric hydrogel matrix (PHM) is a novel tool to manage intraoperative IOAALs. The primary end-point of our study was to verify whether PHM would be able to reduce postoperative air leaks; secondary end-points were the possible reduction of the permanence time of the chest drain (CD) and the hospital length (HL) in the PHM group compared with no treatment.

Detailed description: The management of postoperative air leaks remains an unresolved issue in pulmonary resections. This complication can be present in up to 75% of patients undergoing major lung resections; however, it often resolves spontaneously. In 8% of cases, air leaks can persist for up to 5-7 days post-surgery, and are associated with a higher risk of complications, such as prolonged chest tube duration, increased incidence of postoperative infections and higher medical and non-medical costs. Sealants are non-invasive medical devices that help reduce or eliminate air leaks and bleeding. A recent study showed an increased risk of air leaks in patients undergoing segmentectomies compared to lobar resections; this study is designed to evaluate the efficacy of intraoperative use of Polymeric Hydrogel matrix in achieving aerostasis during anatomical segmental pulmonary resections via VATS or RATS, compared to patients receiving standard of care. All patients meet the eligibility criteria and successfully undergo a minimally invasive segmentectomy will undergo intraoperative evaluation of alveolar air leaks. Those with moderate air leaks (30-60 ml/respiratory act, measured at the Ventilation Mechanical Test, which consists in 1 minute volumetric ventilation with a constant flow and a peak pressure of 22 cmH2O, 12 respiratory rates per minute and a positive end-expiratory pressure (PEEP) of 5 cmH2O), will be randomized to receive Polymeric Hydrogel matrix or no further treatment.The primary endpoint is to evaluate the efficacy in reducing postoperative air leaks secondary to the intraoperative application of Polymeric Hydrogel matrix (measured in days from the first postoperative day to the last day the air leaks are detected), compared to a control group receiving standard of care.The secondary endpoints include the evaluation of the postoperative permanence of chest tube, total length of hospital stay, medical and non-medical costs and postoperative complications up to 40 days of follow-up.

Criteria for eligibility:
Criteria:
Inclusion Criteria: - patients aged > 18 years - undergoing anatomical pulmonary resection (segmentectomy) via VATS or RATS - benign and/or malignant lung disease - No known allergy to any of the components of the device Exclusion Criteria: - Refusal or inability to give informed consent to the study protocol - Age < 18 years - Pregnancy - Chronic Kidney Failure - Allergies or contraindications to any of the Polymeric Hydrogel Matrix components - Patients undergoing pulmonary resections different than segmentectomy (wedge, lobectomy, bilobectomy, pneumonectomy) - Patients undergoing open surgery - More than one chest tube after lung resection

Gender: All

Minimum age: 18 Years

Maximum age: N/A

Healthy volunteers: No

Locations:

Facility:
Name: Thoracic Surgery Unit

Address:
City: Padua
Zip: 35128
Country: Italy

Status: Recruiting

Contact:
Last name: MARCO MAMMANA, MD,PhD

Phone: +390498212442
Email: marco.mammana@aopd.veneto.it

Start date: July 15, 2023

Completion date: July 1, 2025

Lead sponsor:
Agency: University Hospital Padova
Agency class: Other

Source: University Hospital Padova

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT06544200