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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT03471884
Other study ID # 201711003RINB
Secondary ID
Status Recruiting
Phase N/A
First received March 13, 2018
Last updated March 19, 2018
Start date March 2018
Est. completion date December 31, 2018

Study information

Verified date March 2018
Source National Taiwan University Hospital
Contact Ming-Hui Hung, MD, MSc
Phone 02-23123456
Email hung.minghui@gmail.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

A novel nonintubated thoracoscopic technique is promising to enhance recovery after thoracic surgery. However, the effects of nonintubated technique on specific organ protection in not clear yet. In this randomized trial, the effect of nonintubated technique on lung function protection will be evaluated via PaO2/FiO2 ratio, oxidative stress and inflammatory cytokines serially in lung cancer patients undergoing thoracoscopic lobectomy.


Description:

Lung cancer is the leading cause of cancer-related death worldwide. Its incidence is increasingly arising recently. For early-stage non-small cell lung cancer, surgery is the standard treatment that offers best chance of survival. For thoracoscopic lung cancer surgery, tracheal intubation with one-lung ventilation is regarded the standard anesthetic management to establish a safe operating environment. However, complications associated with intubated general anesthesia are not negligible. A novel nonintubated thoracoscopic technique is developing and applied in a variety of thoracic diseases. A previous study showed that nonintubated thoracoscopic lobectomy was feasible and safe in lung cancer patients. Furthermore, nonintubated techniques was also associated with a faster recovery of oral intake, less postoperative complications and shorter hospital stay. The effects of nonintubated thoracoscopic technique on specific organ protection is not clear yet.

The aim of this investigation is to explore the effects of nonintubated thoracoscopic lobectomy on lung function protection in lung cancer patients, comparing with the standard intubated patients as a control. The investigators are going to enrol 82 lung cancer patients and randomize them equally to complete thoracoscopic lobectomy with lymphadenectomy either with a nonintubated technique (n=41) or an intubated technique (n=41). The assessment of lung function will be obtained from serial blood gas analyses using PaO2/FiO2 ratio. Additionally, oxidative stress and inflammatory cytokines will be measured from serial blood samples including 8-isoprostane, malondialdehyde, tumor necrosis factor-α, interleukin-6, interleukin-10, S100-β and neuron specific enolase.


Recruitment information / eligibility

Status Recruiting
Enrollment 82
Est. completion date December 31, 2018
Est. primary completion date December 31, 2018
Accepts healthy volunteers No
Gender All
Age group 20 Years to 99 Years
Eligibility Inclusion criteria

- adults (> 20 year-old), lung cancer patients undergoing thoracoscopic lobectomy

Exclusion criteria

- obesity (BMI > 26 kg/m2)

- previous ipsilateral thoracic surgery

- severe ventilatory insufficiency (oxygen/BiPAP user)

- poor cardiopulmonary function (preop forced expiratory volume at one second (FEV1) <60%, preop left ventricular ejection fraction < 50%)

- autoimmune disease requiring chronic steroids

- patients with difficult airway management, pregnant women

Study Design


Intervention

Procedure:
Nonintubated thoracoscopic lobectomy
Nonintubated general anesthesia using fentanyl, target-controlled infusion of propofol to achieve a bispectral index value between 40 and 60. One-lung ventilation will be achieved via a spontaneous breathing due to iatrogenic pneumothorax.
Intubated thoracoscopic lobectomy
Intubated general anesthesia using 2%-3% sevoflurane and rocuronium to achieve a bispectral index value between 40 and 60. One-lung ventilation will be achieved via a endobronchial tube or blocker with use of mechanical ventilation.

Locations

Country Name City State
Taiwan National Taiwan University Hospital Taipei

Sponsors (1)

Lead Sponsor Collaborator
National Taiwan University Hospital

Country where clinical trial is conducted

Taiwan, 

Outcome

Type Measure Description Time frame Safety issue
Primary Lung function assessment Lung function will be assessed by serial arterial blood gas analyses to obtain oxygenation index (PaO2/FiO2). 12 hours
Secondary Oxidative and systemic inflammatory cytokines. Oxidative and systemic inflammatory cytokines will be measured from serial blood samples, including 8-isoprostane (pg/mL), malondialdehyde (nM), tumor necrosis factor-alpha (pg/mL), interleukin-6 (pg/mL), interleukin-10 (pg/mL), S100-beta (pg/mL), and neuron specific enolase (ng/mL). 24 hours
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