Carcinoma, Non-Small-Cell Lung Clinical Trial
Official title:
Comparison Study of Post-operative Pain and Quality of Life Between Subxiphoid and Intercostal Vedio-assisted Thoracic Surgery for Radical Lung Cancer Resection
One-thirds of patients underwent video-assisted thorascopic surgery (VATS) still have severe pain.Uniportal lobectomy or segmentectomies emerged as a promising and exciting approach for minimally invasive thoracic surgery. However, nearly all reported uniportal VATS lobectomies have been performed via the intercostal route, and chest wall trauma has still occurred. Here,the investigators undertook novel uniportal VATS technique involving a subxiphoid route for pulmonary lobectomies or segmentectomies.We would like to evaluate the post-operative pain and quality of life between Subxiphoid and Intercostal VATS for Lung Cancer.
Is subxiphoid route VATS surgery better than Intercostal VATS surgery for lung cancer?
Video assisted thoracoscopic surgery for lung cancer (VATS) is less traumatic than
traditional open surgery for lung cancer. A novel uniportal VATS technique involving a
subxiphoid route for thoracic surgery has been occured. It is reported that subxiphoid route
VATS surgery is better than Intercostal VATS surgery in post-operative pain and quality of
life, but this has never been documented in a randomized trial. Some surgeons hesitate to use
subxiphoid VATS because it is technically more demanding, others question if the two methods
are oncologically equal. Regardless, VATS has been implemented as a routine method for lung
cancer surgery several places around the world, while Shanghai pulmonary Hospital is one of
the best to perform subxiphoid VATS. The investigators have launched the first randomized
controlled trial in the world comparing the two surgical methods to investigate any
differences in length of hospitalization, postoperative pain, life quality within the first
year.
The investigators include patients with stage I lung cancer, and randomize between subxiphoid
VATS and Intercostal VATS in a design where both the patient and doctors doing general rounds
in the ward are blinded until discharge because the dressing on the surgical wound is
identical, regardless of the surgical method. The surgeon cannot influence clinical decisions
including time to discharge, which is decided by other specialist surgeons. Pain evaluation
is performed 1 time daily and followed 6 months using the VAS-score, life quality is
evaluated continuously during the first 6 months using SF-MPQ-2 questionnaires.
200 patients will be asked to participate in each study at shanghai pulmonary Hospital,china
in collaboration with surgeons from department of thoracic surgery.
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