Peptic Ulcer Perforation Clinical Trial
Official title:
The Feasibility of Fast-track Surgery for Perforated Peptic Ulcers. A Prospective Randomized Clinical Trial
The concept of "enhanced recovery after surgery" has become increasingly popular in elective abdominal surgeries. Yet, the role of this concept has not been described in emergency procedures. Therefore, this study aimed to investigate the feasibility of fast-track surgery in patients with perforated peptic ulcer.
The study is designed as a randomized, controlled clinical study. The patients with a
preoperative diagnosis of perforated peptic ulcer will be recruited for the study. Among
those, the patients with a definitive diagnosis of perforated peptic ulcer confirmed by
surgical exploration will be included.
The patients will be randomized according to their protocol number given automatically by the
registration system of the hospital during admission. The patients who have an odd protocol
number will have conventional surgical protocol, and those who have an even protocol number
will have fast-track surgery protocol.
The conventional surgical protocol for perforated peptic ulcers is composed of regular
general anesthesia, postoperative pain control by intravenous analgesics, removal of
nasogastric tube by the end of 48th postoperative hour, initiation of oral intake after
clinical signs of active bowel movement is observed. Fast-track surgery protocol, however, is
composed of general anesthesia with short-acting agents and the use of regional anesthesia if
possible, removal of nasogastric tube during recovery from anesthesia, aggressive pain
control, initiation of oral intake by the end of 48th postoperative hour.
All of the patients will be scheduled for control gastroscopy in the end of six weeks after
surgery.
Primary end-point is the morbidity and mortality rate. Secondary end-points are length of
hospital stay, readmission rate, endoscopic findings in control gastroscopy.
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