Clinical Trials Logo

Clinical Trial Summary

Comparison of the efficiency of enhanced recovery program after colorectal surgery in elderly patients (≥ 70 yo) and younger patients (< 70 yo). Efficiency will be rated as a function of length of hospital stay, postoperative complications (medical and surgical, as well as adherence to protocol.


Clinical Trial Description

In 1995 Henrik Kehlet described the concept of fast track surgery after colectomy. It consisted of a multimodal and multidisciplinary approach that aimed at controlling the surgical stress response and at mitigating its consequences. Subsequently postoperative recovery is improved and accelerated, which allows a median hospital stay of 2-days after laparoscopic colectomy. The concept of fast track surgery progressively evolved into enhanced recovery programme (ERP). The acceleration of postoperative recovery and the reduction in the duration of hospitalisation are not associated with an increased incidence of surgical complications nor a greater rate of unplanned hospital readmission, but rather result in less medical complications. The economic benefits are obvious.

The elderly present specific physical, metabolic and socio-environmental characteristics that should be considered in case of surgery. Age has been shown to be an independent prognostic factor for postoperative morbidity after colorectal surgery, but this was reported before the development of ERP. Indeed implementation of ERP significantly reduces the rate of postoperative complications, even in the elderly. Increased risk of postoperative morbidity in elderly as compared to younger patients is nevertheless commonly admitted. Moreover adherence of elderly with the items of ERP is usually considered inferior than that of younger patients. Adaptation of ERP to the specificities of elderly is sometimes advocated. All these explain the reluctance of many practitioners to propose ERP in older patients. However recent meta-analyses suggest that implementation of ERP is feasible and efficient in these patients. The retrospective analysis of our first 100 patients introduced in our audit database revealed even similar length of hospital stay for elderly and younger patients.

The investigators therefore compared the length of hospital stay in the elderly and the younger patients and tested the hypothesis of non-inferiority for elderly patients as compared to younger patients. This is a retrospective analysis of 270 consecutive patients scheduled for colorectal surgery, all managed with the same ERP protocol, and prospectively introduced in our audit database. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03620851
Study type Observational
Source University Hospital of Liege
Contact
Status Completed
Phase
Start date September 1, 2018
Completion date September 30, 2018

See also
  Status Clinical Trial Phase
Terminated NCT03746353 - Early Closure Versus Conventional Closure in Postoperative Patients With Low Anteriresection for Rectal Cancer N/A
Recruiting NCT03560180 - Early Diagnosis of Anastomotic Leakage After Colorectal Surgery: Italian ColoRectal Anastomotic Leakage Study Group.
Completed NCT03357497 - Very Early Mobilization of Colorectal Surgery Patients N/A
Recruiting NCT02143336 - Subcuticular Continuous Suture Versus Skin Staples to Reduce Surgical Site Infections in Colorectal Surgery Patients N/A
Completed NCT02846285 - Causes of Low Digestive Bleeding in Proctology N/A
Completed NCT01547572 - Psychological Preparation for Colorectal Surgery: Impact of Video Education N/A
Completed NCT00731978 - NIRF Trial: Near-Infrared Spectroscopy for Intraoperative Restriction of Fluids Trial N/A
Completed NCT00867958 - Compression Anastomosis Using the CAR™ 27 N/A
Terminated NCT00413127 - Perioperative Protective Effects of Lidocaine Phase 2/Phase 3
Recruiting NCT00498290 - The Protocol of Enhanced Recovery After Surgery in Colorectal Surgery N/A
Not yet recruiting NCT03814681 - Postopoperarive Outcomes After Colorectal Surgery in Europe (euroPOWER)
Completed NCT04040647 - Tolerance of Early Postoperative Mobilization and Ambulation
Completed NCT03012802 - Postoperative Outcomes Within an Enhanced Recovery After Surgery Protocol
Completed NCT03922113 - Muscle Function After Intensive Care
Completed NCT02947269 - Prucalopride in Postoperative Ileus Phase 3
Recruiting NCT02999217 - Intravenous Iron for Correction of Anaemia After Colorectal Surgery Phase 4
Completed NCT02543190 - System-Wide Improvement for Transitions After Surgery: The SWIFT Post op Program N/A
Completed NCT01220661 - Safety and Efficacy of One Dose Prophylactic Antibiotic in Laparoscopic Colorectal Surgery Phase 2
Recruiting NCT00773981 - Transrectal Vacuum Assisted Drainage: A New Method of Treating Anastomotic Leakage After Rectal Resection Phase 3
Completed NCT03711487 - The Effect of Foeniculum Vulgare Ironing on Gastrointestinal Recovery After Colorectal Resection Phase 2