An interventional study of 16 F chest tube and 24 F chest tube in Pneumothorax and Pleural Effusion, sponsored by University Hospital, Basel, Switzerland. Recruiting at 1 site in Switzerland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-06.
Sponsored by University Hospital, Basel, Switzerland · Not applicable, Interventional, and Treatment
The aim of the study is to evaluate postoperative pain in patients receiving a small-bore (16F) chest drain compared to those receiving the standard large-bore (24F) chest drain after minimally invasive pulmonary lobectomy and/or segmentectomy.
Lung cancer remains the leading cause of cancer-related death worldwide, and surgical resection remains the treatment of choice for patients with resectable non-small cell lung cancer (NSCLC), particularly in early stages of the disease. Anatomical lung resections such as lobectomy and segmentectomy are commonly performed, increasingly through minimally invasive techniques like video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracoscopic surgery (RATS). Compared to traditional thoracotomy, VATS and RATS has been associated with better postoperative outcomes, including less pain, shorter hospital stays, faster recovery, and improved quality of life.
After lung resections, the standard postoperative management involves the insertion of a chest drain to remove air and fluid from the pleural space and monitor for complications such as air leaks or bleeding. Traditionally, most thoracic surgery centres use a single large-bore chest tube, typically 24F in size, which remains in place at least until the first postoperative day. However, this practice is not based on strong evidence, and there is currently no consensus on the optimal size of the chest drain. In fact, removal of the chest tube has been shown to significantly improve ventilatory function and reduce pain, particularly in the early postoperative period.
The Chest Drain 16F vs 24F Study investigates whether the use of a smaller-bore chest drain (16F) leads to less postoperative pain compared to the standard large-bore 24F drain in patients undergoing minimally invasive pulmonary lobectomy and/or segmentectomy. In addition to comparing the tube sizes, the trial explores the safety and feasibility of early chest drain removal, defined as removal within 2 to 6 hours after surgery, provided that specific clinical criteria are met (e.g., minimal air leak and no signs of complications). While retrospective data and small prospective studies suggest that early removal and the use of smaller tubes may be beneficial, high-quality prospective data are lacking. This study aims to provide evidence to potentially change clinical practice by reducing patient discomfort without compromising safety.
183 studies on the registry are indexed under Pneumothorax; 41 are open to participants now.
This study's planned enrollment of 124 is above the median of 100 across 111 interventional studies indexed under Pneumothorax.
Browse Pneumothorax studies →University Hospital, Basel, Switzerland is the lead sponsor of 990 studies on the registry; 189 are open to participants now.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
The New York Heart Association’s four classes of how much heart failure limits physical activity.
Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.
A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.
GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².
Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
NYHA class (heart failure)
The New York Heart Association’s four classes of how much heart failure limits physical activity.
Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Child-Pugh class
A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
GFR and eGFR (kidney filtering)
GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².
Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Platelets
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
small-bore (16F) chest tubes, removal 2h until 6h after end of skin closure
Device: 16 F chest tube · Procedure: Early removal
small-bore (16F) chest tubes, removal 1 day postoperative
Device: 16 F chest tube · Procedure: Standard removal
large-bore (24F) chest tubes, removal 2h until 6h after end of skin closure
Device: 24 F chest tube · Procedure: Early removal
large-bore (24F) chest tubes, removal 1 day postoperative
Device: 24 F chest tube · Procedure: Standard removal
Insertion of 16F chest tube
Also known as: Small-bore chest tube
Insertion of 24F chest tube
Also known as: Large-bore chest tube
Removal 2-6h after end of skin closure
Removal 1day postoperative
Postoperative chest pain
Postoperative pain related to the placed chest drain (16F versus 24F), measured on a visual analogue scale (VAS) while coughing at different time points from skin closure until standard chest drain removal. The VAS is a horizontal line (100 mm) labelled from "no pain" on the left (0 mm) to "most extreme pain experienced" on the right (100 mm). Chest pain intensity is measured and recorded at rest and while coughing. For the current pain rating, the patient must be shown their last rating for comparison. The patient marks their information with a vertical line on the horizontal score line of the sheet paper. If needed, assistance with filling out the form will be provided. The evaluation is carried out by measuring the distance from the low anchor point to the marking; the recorded values are expressed in millimetres (0-100).
Time frame: 4 and 6 hours after last suture; twice daily from day 1 to day 3 postoperative or until tube removal; on discharge home; on follow up day 30 and 180.
Postoperative acute pain relief while coughing
Postoperative acute pain relief while coughing in the other 5 pairwise comparisons. Pain is measured on a visual analogue scale (VAS) while coughing. The VAS is a horizontal line (100 mm) labelled from "no pain" on the left (0 mm) to "most extreme pain experienced" on the right (100 mm).
Time frame: 4 and 6 hours after last suture; twice daily from day 1 to day 3 postoperative or until tube removal; on discharge home; on follow up day 30 and 180.
Postoperative acute pain relief at rest
Postoperative acute pain relief at rest measured by an analgesia consumption adjusted pain intensity on a visual analogue scale at different time points in all subgroup comparisons. Pain is measured on a visual analogue scale (VAS) while coughing. The VAS is a horizontal line (100 mm) labelled from "no pain" on the left (0 mm) to "most extreme pain experienced" on the right (100 mm).
Time frame: 4 and 6 hours after last suture; twice daily from day 1 to day 3 postoperative or until tube removal; on discharge home; on follow up day 30 and 180.
Analgesia consumption
Intraoperative and postoperative analgesia consumption at different time points.
Time frame: 4 and 6 hours after last suture; twice daily from day 1 to day 3 postoperative or until tube removal; on discharge home; on follow up day 30 and 180.
Duration of the thoracic drainage
Duration of the thoracic drainage in hours from skin closure until chest tube removal if the air flow is ≤ 20 ml/min.
Time frame: From 2 until 6 hours after last suture; twice daily from day 1 until the chest tube is removed.
Fluid output
Duration of fluid output reported per 24h measured in ml/kg/24h with Medela Thopaz+™ until the chest tube is removed.
Time frame: From 2 until 6 hours after last suture; twice daily from day 1 until the chest tube is removed.
Length of hospital stay
Length of hospital stay in nights from the end of the operation to the time when the patient is fit for discharge.
Time frame: Patients are discharged from hospital on the 3rd to 7th day, or stay up to the 10th day in case of prolonged air leak or re-operation.
Re-hospitalization
Re-hospitalization due to pleural complications.
Time frame: After hospital discharge until 180-day follow up.
Postoperative morbidity
Postoperative morbidity related to the medical device and/or procedure. Respiratory, thoracic, mediastinal and cardiac adverse events (AE). Adverse events are recorded and described according to CTCAE 5.0.
Time frame: During hospitalization and follow up until 30-day follow up.
Pleural complications
Pleural complications after early removal of chest tubes.The pleural complications will be graded according to Common Terminology Criteria for Adverse Events (CTCAE 5.0).
Time frame: During hospitalization and follow up until 30-day follow up.
Mortality
In-hospital mortality; 30-day and 180-day mortality.
Time frame: During hospitalization; 30 and 180 days after hospital discharge.
Chronic pain
Chronic pain intensity and pain quality assessment while coughing and at rest on 30/180-day after hospital discharge.
Time frame: 30 and 180 days after hospital discharge.
Quality of life assessment
Quality of life measured by Short Form 12 (SF-12) questionnaire.
Time frame: Preoperative and at 30/180-day follow up.
Started May 2025 (actual). Primary completion is estimated for Apr 2027, 23 months after the start.
Of 42 interventional studies with no phase under Pneumothorax, half reached primary completion within 26 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 34. This study's planned 23 months is below that.
How these figures are worked out, and which studies are left out of them.
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