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NCT00606944 · REGISTRY CONDITION SEARCH

Fast-track Rehabilitation After Elective Colorectal and Small Bowel Resection

Found through the registry condition index, not selected as a treatment recommendation. This discovery collection was restricted to studies with posted results.

Phase
NA
Status at capture
COMPLETED
Registry last update
2012-08-21

The purpose of this study is to address the question of whether or not oral alimentation and ambulation exercise should be begun early in patients following laparoscopic colorectal surgery compared to the classical diet and ambulation which depends on reappearance of functional intestinal transit. Early oral alimentation following laparoscopic colorectal surgery may decrease hospital stay and facilitate earlier discharge with comparable postoperative morbidity.

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

Who could take part
eligibility Criteria
Inclusion Criteria: * • Patients between 20 - 80 years old * Class ASA (American Society of Anesthesiology) I, II or III, +/- E * Patient willing to participate in the study * Patient who understands and accepts to sign the informed consent form * Patient who will undergo elective colorectal resection using laparoscopic surgery defined as follows: patients who received one of the following surgery:right hemicolectomy, left hemicolectomy, anterior resection with primary anastomosis, and low anterior resection with loop ileostomy for fecal diversion Exclusion Criteria: * • Class ASA IV or V patient * Documented problem of gastro-intestinal motility * Combined resection of other organ than the colorectum * Presence of obstructive colorectal cancer associated with dilatation of the proximal gastrointestinal tract * Presence of residual peritoneal carcinosis at the end of surgery * Previous history of intra-abdominal surgery except simple appendectomy, cholecystectomy, or hysterectomy for uterine myoma * Creation of colo-rectal, colo-anal or ileo-anal anastomosis without loop ileostomy * Any per-surgery discovery which requires the use of a gastric drainage procedure following surgery * Any post-surgery change in patient condition which requires naso-gastric tube holding after surgery
healthy Volunteers
false
maximum Age
80 Years
minimum Age
20 Years
sex
ALL
std Ages
  1. ADULT
  2. OLDER_ADULT
Treatment arms and interventions
arm Groups
  1. description
    fast-track rehabilitation with early ambulation and diet after elective colorectal resection
    intervention Names
    1. Behavioral: fast-track rehabilitation
    label
    ERP group
    type
    EXPERIMENTAL
  2. description
    traditional, conventional care group
    label
    control group
    type
    NO_INTERVENTION
interventions
  1. arm Group Labels
    1. ERP group
    description
    fast-track rehabilitation with early ambulation and diet after elective colorectal resection
    name
    fast-track rehabilitation
    type
    BEHAVIORAL
Study design
allocation
RANDOMIZED
intervention Model
PARALLEL
masking Info
masking
NONE
primary Purpose
TREATMENT
Enrollment
count
200
type
ACTUAL
Registered outcome plans (not posted results)
primary Outcomes
  1. description
    discharge criteria 1. Tolerance of consecutive 3 soft bland diet 2. Unassisted ambulation 3. No necessity of analgesics 4. Afebrile without major complication 5. Willing to discharge
    measure
    the Length of Hospital Stay
    time Frame
    at discharge
  2. description
    score measured by the Visual Analog Scale
    measure
    Pain
    time Frame
    at discharge
  3. description
    measured by SF-36
    measure
    Quality of Life
    time Frame
    at discharge
  4. measure
    Postoperative Complication During the First Admission
    time Frame
    at discharge
  5. description
    recovery criteria must include all of the following 1. Tolerance of consecutive 3 soft bland diet 2. Unassisted ambulation 3. No necessity of analgesics 4. Afebrile without major complication
    measure
    Recovery
    time Frame
    at discharge
secondary Outcomes
  1. measure
    Readmission Rate
    time Frame
    at postoperative day 30
  2. description
    score measured by the Visual Analog Scale
    measure
    Pain
    time Frame
    at postoperative day 30
  3. description
    measured by SF-36
    measure
    Quality of Life
    time Frame
    at postoperative day 30
  4. measure
    Postoperative Complication
    time Frame
    at postoperative day 30
Full study description
brief Summary
The purpose of this study is to address the question of whether or not oral alimentation and ambulation exercise should be begun early in patients following laparoscopic colorectal surgery compared to the classical diet and ambulation which depends on reappearance of functional intestinal transit. Early oral alimentation following laparoscopic colorectal surgery may decrease hospital stay and facilitate earlier discharge with comparable postoperative morbidity.
detailed Description
Traditionally, patients who received laparoscopic colorectal surgery were treated with the classical protocol including the use of a naso-gastric tube and starvation for several postoperative days till the recovery of bowel movement, or bed resting at immediate postoperative period followed by ward ambulation at the postoperative day 1 or 2. Restarting the oral alimentation is based on gas or feces reappearance after surgery and usually this is possible at several days following surgery. However, prolonged starvation might be uncomfortable for the patient as well as increasing his postoperative hospital stay. Recently, several studies reported the efficacy of early rehabilitation protocols after intestinal surgery, showing that early oral alimentation could reduce the length of hospital stay and cost of hospitalization without significant increase of postoperative complications, compared to traditional management. This prospective, randomized study was designed to evaluate the effectiveness of a postoperative care pathway using rehabilitation with early ambulation and diet for patients undergoing elective laparoscopic colorectal resection compared with the traditional postoperative care. In order to conduct this study, patients having a laparoscopic colon resection will be randomly attributed to enhanced recovery program group or control group, which is divided based on the postoperative management protocol.
Source references
references
  1. citation
    Lee SM, Kang SB, Jang JH, Park JS, Hong S, Lee TG, Ahn S. Early rehabilitation versus conventional care after laparoscopic rectal surgery: a prospective, randomized, controlled trial. Surg Endosc. 2013 Oct;27(10):3902-9. doi: 10.1007/s00464-013-3006-4. Epub 2013 May 25.
    pmid
    23708720
    type
    DERIVED
  2. citation
    Lee TG, Kang SB, Kim DW, Hong S, Heo SC, Park KJ. Comparison of early mobilization and diet rehabilitation program with conventional care after laparoscopic colon surgery: a prospective randomized controlled trial. Dis Colon Rectum. 2011 Jan;54(1):21-8. doi: 10.1007/DCR.0b013e3181fcdb3e.
    pmid
    21160309
    type
    DERIVED
Source notices and limitations
    Discovery and provenance
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      nct id
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        exact text
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      query cond
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      query disease state id
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      source file
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    Preserved source evidence · Not medical advice