NCT03172052

Brief Summary

interventional randomized clinical trial will be done at Assuit University Hospital ( Chest Department and Caridothoracic surgery department ),and all patients presented with complex septate pleural effusion in whom the symptoms excepted to be relieved by pleural fluid drainage will be included in our study within the two next years.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
100

participants targeted

Target at P50-P75 for phase_4

Timeline
Completed

Started Aug 2017

Typical duration for phase_4

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 21, 2017

Completed
11 days until next milestone

First Posted

Study publicly available on registry

June 1, 2017

Completed
2 months until next milestone

Study Start

First participant enrolled

August 1, 2017

Completed
1.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2019

Completed
1.1 years until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2020

Completed
Last Updated

June 6, 2017

Status Verified

June 1, 2017

Enrollment Period

1.8 years

First QC Date

May 21, 2017

Last Update Submit

June 3, 2017

Conditions

Outcome Measures

Primary Outcomes (1)

  • measurement of adhesiolysis success

    Failure of the procedure: still presence of intra pleural adhesion by chest sonoar. Partially successful: incomplete removal of intra pleural adhesions. Successful: complete removal of intra pleural adhesions.

    28 days

Study Arms (4)

streptokinase instillation

EXPERIMENTAL

Chemical adhesiolysis by instillation of streptokinase at a dose of 250,000 I.U dissolved in 40 ml of normal saline will be instil in the pleural cavity through the chest tube. we planning to continue the daily instillation as long as the drained fluid volume is \>100 cc with a maximum of 14 doses and to stop further instillation if severe complication occurred and if drained fluid through the tube was \<100 cc in 24 h provided that tube is patent and properly positioned.

Drug: streptokinaseDrug: MESNA (2-mercaptoethane sulfonate Na)Device: Medical thoracoscopyDevice: Video assisted thoracoscopy (VATS)

instillation of MESNA

EXPERIMENTAL

Chemical adhesiolysis by instillation of MESNA at a dose of 1800 mg of MESNA i.e. 3 ampoules ( each ampoule contains 3ml and each ml contains 200 mg of MESNA) will be diluted with 20ml of Normal Saline and will be injected into the pleural cavity through the chest tube for three consecutive days.

Drug: streptokinaseDrug: MESNA (2-mercaptoethane sulfonate Na)Device: Medical thoracoscopyDevice: Video assisted thoracoscopy (VATS)

Medical thoracoscopy procedure

EXPERIMENTAL

Medical thoracoscopy procedure will be carried at endoscopy unit at chest department via, semi rigid thoracoscope

Drug: streptokinaseDrug: MESNA (2-mercaptoethane sulfonate Na)Device: Medical thoracoscopyDevice: Video assisted thoracoscopy (VATS)

Video assisted thoracoscopy (VATS)

EXPERIMENTAL

Video assisted thoracoscopy (VATS) at cardiothoracic surgery department.

Drug: streptokinaseDrug: MESNA (2-mercaptoethane sulfonate Na)Device: Medical thoracoscopyDevice: Video assisted thoracoscopy (VATS)

Interventions

• Chemical adhesiolysis by instillation of streptokinase at a dose of 250,000 I.U dissolved in 40 ml of normal saline will be instil in the pleural cavity through the chest tube. we planning to continue the daily instillation as long as the drained fluid volume is \>100 cc with a maximum of 14 doses and to stop further instillation if severe complication occurred.

Also known as: sedonase
Medical thoracoscopy procedureVideo assisted thoracoscopy (VATS)instillation of MESNAstreptokinase instillation

• Chemical adhesiolysis by instillation of MESNA at a dose of 1800 mg of MESNA i.e. 3 ampoules ( each ampoule contains 3ml and each ml contains 200 mg of MESNA) will be diluted with 20ml of Normal Saline and will be injected into the pleural cavity through the chest tube for three consecutive days.

Medical thoracoscopy procedureVideo assisted thoracoscopy (VATS)instillation of MESNAstreptokinase instillation

Medical thoracoscopy procedure will be carried at endoscopy unit at chest department via, semi rigid thoracoscope (LTF; Olympus; Tokyo, Japan).

Medical thoracoscopy procedureVideo assisted thoracoscopy (VATS)instillation of MESNAstreptokinase instillation

Video assisted thoracoscopy (VATS) at cardiothoracic surgery department.

Medical thoracoscopy procedureVideo assisted thoracoscopy (VATS)instillation of MESNAstreptokinase instillation

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients with symptomatic pleural effusion in whom the symptoms excepted to be relieved by pleural fluid drainage.
  • Presence of intrapleural adhesions as documented sonographically.
  • Difficult thoracentesis.
  • Failure of satisfactory pleural fluid drainage 24 hours following intercostal tube (ICT) placement provided that the tube was properly positioned and not obstructed.
  • Written consent, free and informed.

You may not qualify if:

  • Contraindications for streptokinase instillation i.e. (Previous allergic reaction, bronchopleural fistula, trauma or surgery within 48 hrs, history of hemorrhagic stroke, coagulation defects and previous streptokinase thrombolysis).
  • Patients who are unfit for general anaesthesia.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Pleural Effusion

Interventions

StreptokinaseMesnaThoracic Surgery, Video-Assisted

Condition Hierarchy (Ancestors)

Pleural DiseasesRespiratory Tract Diseases

Intervention Hierarchy (Ancestors)

EndopeptidasesPeptide HydrolasesHydrolasesEnzymesEnzymes and CoenzymesPlasminogen ActivatorsBlood Coagulation FactorsBlood ProteinsProteinsAmino Acids, Peptides, and ProteinsAlkanesulfonatesAlkanesulfonic AcidsAlkanesHydrocarbons, AcyclicHydrocarbonsOrganic ChemicalsSulfhydryl CompoundsSulfur CompoundsSulfonic AcidsSulfur AcidsThoracoscopyEndoscopyDiagnostic Techniques, SurgicalDiagnostic Techniques and ProceduresDiagnosisVideo-Assisted SurgeryMinimally Invasive Surgical ProceduresSurgical Procedures, OperativeThoracic Surgical Procedures

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, CARE PROVIDER
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
assistent lecturer of Chest Department

Study Record Dates

First Submitted

May 21, 2017

First Posted

June 1, 2017

Study Start

August 1, 2017

Primary Completion

June 1, 2019

Study Completion

June 30, 2020

Last Updated

June 6, 2017

Record last verified: 2017-06