Postoperative Ileus Clinical Trial
Official title:
Electroacupuncture for Postoperative Ileus After Laparoscopic Colorectal Surgery: a Randomised Sham-controlled Pilot Study
Postoperative ileus remains a significant medical problem after colorectal surgery that adversely influences patients' recovery and prolongs hospital stay. In fact, a substantial portion of the overall hospitalisation period after colorectal surgery is attributed to the time it takes for ileus to resolve. Although laparoscopic colorectal surgery has been proven to be associated with better short-term clinical outcomes including faster return of gastrointestinal function than open surgery, the duration of postoperative ileus in the laparoscopic arm is still reported to be as long as 4 days in most of the randomised trials. Additional measures are thus necessary to further enhance the gastrointestinal recovery after laparoscopic colorectal surgery in order to maximise its benefits, and acupuncture may be one of the options. Acupuncture is widely accepted in China as well as throughout the world as an effective treatment option for the management of postoperative nausea and vomiting and various functional gastrointestinal disorders. Its role in treating postoperative ileus, however, is less clear, and data from the Chinese as well as the Western literature are scarce. We therefore propose to carry out a prospective randomised sham-controlled pilot study to assess the efficacy of electroacupuncture in treating postoperative ileus after laparoscopic colorectal surgery. The acupoints relevant to the treatment of abdominal distension and constipation, including Zusanli (stomach meridian ST-36), Sanyinjiao (spleen meridian SP-6), Hegu (large intestine meridian LI-4), and Zhigou (triple energizer meridian TE-6) will be used.
Status | Completed |
Enrollment | 165 |
Est. completion date | October 2010 |
Est. primary completion date | October 2010 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | N/A and older |
Eligibility |
Inclusion Criteria: 1. Consecutive patients undergoing elective laparoscopic resection of colonic and upper rectal cancer without the need of conversion 2. Patients with American Society of Anaesthesiologists grading I-III 3. Informed consent available Exclusion Criteria: 1. Patients undergoing laparoscopic low anterior resection with total mesorectal excision, abdominoperineal resection, and total/proctocolectomy 2. Patients undergoing simultaneous laparoscopic resection of colorectal cancer and other coexisting intraabdominal diseases (e.g. liver metastasis, symptomatic gallstones) 3. Patients undergoing laparoscopic resection of colorectal cancer with en-bloc resection of surrounding organs (e.g. small bowel, urinary bladder) 4. Patients who developed intraoperative problems or complications (e.g. bleeding, tumour perforation) that required conversion 5. Patients with intestinal obstruction 6. Patients with previous history of abdominal surgery 7. Patients with stoma creation 8. Patients with evidence of peritoneal carcinomatosis 9. Patients who are expected to receive epidural opioids for postoperative pain management 10. Patients who are allergic to acupuncture needles |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
China | Surgical Wards 4C and 4D, Prince of Wales Hospital, Shatin | Hong Kong SAR |
Lead Sponsor | Collaborator |
---|---|
Chinese University of Hong Kong |
China,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Time to defaecation, measured in days, from the time the laparoscopic surgery ends till the first observed passage of stool | Up to 1 month | No | |
Secondary | Time of first passing flatus reported by the patients (days) | Up to 1 month | No | |
Secondary | Time to resume normal diet (days) | Up to 1 month | No | |
Secondary | Time to walk independently (days) | Up to 1 month | No | |
Secondary | Duration of hospital stay (days) | Up to 1 month | No | |
Secondary | Pain scores on visual analogue scale (from 0 which implies no pain at all, to 10 which implies the worst pain imaginable) on the first 3 postoperative days | Up to 1 month | No | |
Secondary | Postoperative analgesic requirement (number of doses on 50-mg Pethidine). | Up to 1 month | No |
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