Clinical and Economical Evaluation of Colorectal Surgery in Ambulatory Care — Colon-Ambu  

Colorectal Surgery Clinical Trial

Official title: Clinical and Economical Evaluation of Colorectal Surgery in Ambulatory Care

Status Recruiting

Clinical Trial Summary

Enhanced recovery after surgery (ERAS) significantly decreases mortality, morbidity and hospital length of stay without increasing the rate of re-hospitalization. It reduces psychologic stress caused by surgery and decreases postoperative complications about 50 %, especially in colorectal surgery. ERAS is now the object of several Good Practices Recommendations and is about to become the reference strategy.

The development of ambulatory surgery is a French national concern. Its interest has been demonstrated in many surgical fields. It requires a reflection centered on the patient and a health care pathway organization involving all health care actors.

While hospitalization is still the standard practice for colonic surgery, the objective of this study is to evaluate the medical and economic impact of an ambulatory care for colorectal surgery.

Ambulatory care will be compared to standard hospitalization of patients who benefit from the ERAS program.

Clinical Trial Description

Enhanced recovery after surgery (ERAS) significantly decreases mortality, morbidity and hospital length of stay without increasing the rate of re-hospitalization. It reduces psychologic stress caused by surgery and decreases postoperative complications about 50 %, especially in colorectal surgery. ERAS is now the object of several Good Practices Recommendations and is about to become the reference strategy.

The development of ambulatory surgery is a French national concern. Its interest has been demonstrated in many surgical fields. It requires a reflection centered on the patient and a health care pathway organization involving all health care actors. Multiple interests have been shown:

• Equivalent mortality and/or morbidity compared with standard hospitalizations

• Medical and psychological benefits

• Individualized and less invasive health care pathways, in favor of patient's autonomy

• Multidisciplinary approach and innovative care

• Heath care costs management (decrease of hospital length of stay, optimization of operating rooms).

Ambulatory colectomies feasibility is recognized since 2013-2014 in France (Dr. Gignoux, MD in Lyon and Dr. Chasserant, MD in Le Havre). These ambulatory procedures are implemented in few expert centers with significant experience (more than 100 patients in Le Havre and more than 85 patients in Lyon) but several human and organizational limitations slow this innovative care.

The risk of complications does not seem to be increased on condition of anticipate and provide a postoperative follow-up at home.

While hospitalization is still the standard practice for colonic surgery, the objective of this study is to evaluate the medical and economic impact of an ambulatory care for colorectal surgery.

Ambulatory care will be compared to standard hospitalization of patients who benefit from the ERAS program. ;

Related Conditions & MeSH terms

• Colorectal Surgery

• NCT number: NCT03760939
• Study type: Interventional
• Source: IHU Strasbourg
• Contact: Didier Mutter, MD, PhD
• Phone: +33(0)369550553
• Email: didier.mutter@chru-strasbourg.fr
• Status: Recruiting
• Phase: N/A
• Start date: January 3, 2019
• Completion date: April 2024