Wedge Resection or Parietal Pleurectomy for the Treatment of Recurrent Pneumothorax (WOPP)

  • STATUS
    Recruiting
  • End date
    Jun 16, 2022
  • participants needed
    360
  • sponsor
    Otto-von-Guericke University Magdeburg
Updated on 16 March 2020
Investigator
Thorsten Walles, MD
Primary Contact
Universit tsklinikum Erlangen (8.7 mi away) Contact
+31 other location
thoracic surgery
atelectasis
pulmonary disease
collapse
pleurectomy
wedge resection

Summary

Primary spontaneous pneumothoraces (PSP) represent a significant public health problem, occurring in young healthy subjects without pre-existing lung disease or precedent medical intervention or trauma with a reported incidence of up to 18-28/100 000 per year. PSP treatment often requires thoracic surgery to restore lung expansion and to prevent de novo lung collapse. Despite the presence of elaborated guidelines by the British Thoracic Society (BTS) postulating apical wedge resection of the lung and total parietal pleurectomy (WRPP), the majority of German hospitals gathered experience especially in limiting surgery to cost-saving partial apical parietal pleurectomy or yet apical pleural abrasion (PP). Until today, hardly any reliable data exist to analyze and compare the varying treatment approaches regarding efficacy and efficiency. In this randomized, multi-centric clinical trial, both treatment approaches will be compared. For this purpose, candidates for surgery will be randomized into one of the two treatment groups after informed consent has been obtained. Patients will be followed for 2 years by the participating centres to be able to evaluate the long-term effect of the surgical interventions.

Description

The trial will be conducted at the major thoracic surgery units in Germany. Each centre can include patients on the basis of the presence of a PSP and the inclusion and exclusion criteria.

After informed consent has been obtained from the study participants, each has to fill out the standardized short-form health survey (SF-36) questionnaire and the visual analogue scale (VAS) to determine baseline parameters for the (current) state of health and pain level.Randomization into the two interventional groups is carried out before surgery.

Patients are operated according to good clinical practice either by pleurectomy alone (PP) or total parietal pleurectomy with apical wedge resection of the pulmonary apex (WRPP). Procedure related parameters (like operation time, applied suture materials including staplers) are documented.

The postoperative care is subject to each participating centre's standards. The postoperative course is evaluated (mortality, morbidity, duration of tube drainage, re-interventions or operations, length of stay, need for blood substitutions).

To evaluate the long term effect of the surgical intervention, all study participants are followed for 2 years.

Details
Treatment Wedge resection, parietal pleurectomy
Clinical Study IdentifierNCT01855464
SponsorOtto-von-Guericke University Magdeburg
Last Modified on16 March 2020

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Eligibility

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Inclusion Criteria

Is your age between 15 yrs and 40 yrs?
Gender: Male or Female
Do you have any of these conditions: Pleural Diseases or Recurrent Pneumothorax or Pleural disorder or Pneumothorax?
recurrence of a primary pneumothorax
persistent primary pneumothorax
patient preference (in primary events)

Exclusion Criteria

presence of a pulmonal fistula
underlying lung disease
previous thoracic surgery (except tube thoracostomy)
previous pleurodesis
conversion thoracotomy
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