Tubeless Strategy for Enhanced Recovery After Sublobar Resection

Condition(s) studied

Investigational drug(s) / intervention(s)

Laryngeal Mask Airway: Airway management using a laryngeal mask airway with spontaneous ventilation during thoracoscopic surgery.

Thoracic Paravertebral Block with Local Anesthetic: Thoracic paravertebral block using local anesthetic (e.g., ropivacaine) for intraoperative and postoperative analgesia.

Non-intubated Anesthesia: General anesthesia with spontaneous ventilation without endotracheal intubation.

Double-lumen Endotracheal Tube: Double-lumen endotracheal intubation for one-lung ventilation under general anesthesia.

Chest Tube Drainage: Routine placement of a chest tube (18-22 Fr) with water-seal drainage postoperatively.

Study summary

This is a prospective, randomized controlled clinical trial conducted at a single center. The study aims to evaluate whether a "tubeless" strategy can enhance recovery for patients undergoing minimally invasive thoracoscopic sublobar resection (wedge or segment resection) for small lung nodules.

Participants will be randomly assigned to one of two groups:

* The experimental group will receive the "tubeless" strategy, which includes non-endotracheal intubation anesthesia (using a laryngeal mask) and no routine chest tube drainage after surgery.
* The control group will receive the traditional strategy, which includes double-lumen endotracheal intubation anesthesia and routine chest tube drainage.

The main goal is to compare the rate of achieving high-quality fast-track recovery at 24 hours after surgery between the two groups. This study will provide evidence on whether the tubeless approach can help patients recover faster and more comfortably without compromising safety.

Eligibility

Primary outcome measure(s)

• 24-hour high-quality recovery rate — 24 hours after surgery
  Composite endpoint defined as meeting all of the following criteria at 24 hours postoperatively: (1) meeting standardized discharge criteria (stable vital signs, controlled pain, autonomous ambulation); (2) Quality of Recovery-15 (QoR-15) score ≥130 (range 0-150; higher scores indicate better recovery); and (3) absence of Clavien-Dindo grade ≥II respiratory complications.

Trial sites (1)

More The First Affiliated Hospital of Guangzhou Medical University trials in China

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