Status:
NOT_YET_RECRUITING
Video-assisted Thoracoscopic Surgery (VATS) Has Revolutionised Management of Complicated PPE, Our Study to Determine VATS Decortication Technique is Needed, Compared to VATS Debridement in PPE, Also RAPID Score and Pleural US Parameters Can Predict Which VATS Procedure is Needed.
Lead Sponsor:
Assiut University
Conditions:
Parapneumonic Effussion
Eligibility:
All Genders
18+ years
Phase:
NA
Brief Summary
Video-assisted thoracoscopic surgery (VATS) has revolutionised management of complicated parapneumonic effusion ( PPE). So our study is prospective cohort study will be conducted at Departments of Che...
Detailed Description
* Type of the study: Prospective Cohort Study. * Study Group: VATS debridement versus VATS decortication. * Study Setting: Departments of Chest Diseases and Cardiothoracic Surgery, Assiut University H...
Eligibility Criteria
Inclusion
- Age \> 18 years
- Patients diagnosed with PPE who are confirmed by (aspiration of frank pus from pleural cavity, positive culture for bacterial infection, pleural fluid with a pH ⩽7.2 (measured by blood gas analyser), low glucose level (⩽3 mmol/L or ⩽55 mg•dL-1), lactate dehydrogenase (LDH) \>200 IU/L) in a patient with clinical evidence of infection \[6\].
- Failed resolution of parapneumonic effusion:
- Given a patient-to-patient variability in response to medical treatment, therapeutic pleurocentesis and ICT drainage, a MDT involving consultant cardiothoracic surgeons and consultant pulmonologist are to discuss enrolled cases individually , reach consensus, and declare failure of medical treatment or ICT drainage and need for surgical intervention , based on combination of clinical , laboratory, and radiological parameters (persistence of fever. Elevated Wbcs, respiratory symptoms, pleural fluid loculi inaccessible by ICT, lung entrapment despite complete drainage of fluid or large bronchopleural fistula
Exclusion
- Patients unfit for/ or declining surgical intervention.
- Iatrogenic or traumatic pyothorax.
- Haemothorax or chylothorax regardless the aetiology.
- Exudative pleural effusion due to medical conditions other than pneumonia (suspected or proven Para malignant effusion, associated pulmonary embolism, autoimmune, pancreatic or oesophageal disease, gynaecological disorder, and drug-induced pleural effusion).
Key Trial Info
Start Date :
October 25 2025
Trial Type :
INTERVENTIONAL
Allocation :
ESTIMATED
End Date :
February 10 2028
Estimated Enrollment :
95 Patients enrolled
Trial Details
Trial ID
NCT07188714
Start Date
October 25 2025
End Date
February 10 2028
Last Update
September 23 2025
Active Locations (1)
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1
Assiut university- Faculty of medicine
Asyut, Assiut Governate, Egypt, 71111