Enhanced Recovery Versus Standard Care After Emergency Abdominal Surgery in Patients Requiring Emergency Laparotomy

June 10, 2026 updated by: Sarfraz Hussain, Recep Tayyip Erdogan Hospital Pakistan - Muzaffargarh

Comparison of Enhanced Recovery Protocol After Surgery Versus Conventional Care in Emergency Laparotomy

This study aims to compare an Enhanced Recovery After Surgery (ERAS) protocol with conventional postoperative care in adults undergoing emergency laparotomy for intestinal obstruction or intestinal perforation.

The main question this study aims to answer is:

• Does the ERAS protocol reduce surgical site infections compared with conventional care after emergency laparotomy?

Researchers will also compare other recovery outcomes between the two groups, including length of hospital stay, occurrence of paralytic ileus (temporary loss of bowel function), time to first bowel movement, and time to start taking fluids by mouth after surgery.

A total of 102 participants will be enrolled and randomly assigned to one of two groups. One group will receive postoperative care according to the ERAS protocol, while the other group will receive conventional postoperative care. All participants will undergo emergency laparotomy using standard surgical and anesthetic techniques.

Participants will:

  • Undergo emergency laparotomy for intestinal obstruction or intestinal perforation.
  • Receive either ERAS-based postoperative care or conventional postoperative care.
  • Be monitored during their hospital stay for recovery and postoperative complications.
  • Be assessed for bowel function recovery, ability to tolerate oral fluids, and length of hospital stay.
  • Be followed for 30 days after surgery to determine whether a surgical site infection develops.

The researchers hypothesize that patients managed with the ERAS protocol will have a lower frequency of surgical site infections and improved postoperative recovery compared with those receiving conventional care.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

102

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Muzaffargarh, Punjab Province, Pakistan, 34200
        • Recep Tayyip Erdogan Hospital Muzaffargarh

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • acute intestinal obstruction or intestinal perforation
  • planned for emergency laparotomy

Exclusion Criteria:

  • Pregnant women
  • Patients on chronic steroids
  • Chronic obstructive pulmonary disease
  • Malignant ulcers confirmed by histopathological examination
  • laparoscopic surgeries
  • Acute abdominal trauma
  • Patients who require postoperative intensive care unit (ICU) care

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: ERAS Protocol Group
Participants undergoing emergency laparotomy will receive postoperative care according to the Enhanced Recovery After Surgery (ERAS) protocol.
Procedure: Enhanced Recovery After Surgery
A standardized multimodal perioperative care pathway applied to patients undergoing emergency laparotomy. The protocol includes pre-defined components for preoperative optimization, intraoperative management, and postoperative care. Postoperative elements include early mobilization, early initiation of oral fluids and diet, optimized multimodal analgesia, early removal of tubes/drains when appropriate, and structured fluid management.
Active Comparator: Conventional Care Group
Participants undergoing emergency laparotomy will receive standard postoperative care as routinely practiced in the surgical unit.
Procedure: Conventional Postoperative Care
Standard postoperative management routinely practiced in the surgical unit for patients undergoing emergency laparotomy. Care includes traditional postoperative monitoring, routine analgesia, delayed initiation of oral intake, standard mobilization practices, and conventional fluid and supportive management.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Surgical Site Infection
Time Frame: From enrollment within 30 days postoperatively
Frequency of surgical site infection (superficial and deep) occurring within 30 days after emergency laparotomy will be assessed and compared between the Enhanced Recovery After Surgery (ERAS) group and the conventional care group. Surgical site infection will be defined and classified according to standard surgical infection criteria as specified in the study protocol
From enrollment within 30 days postoperatively

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Hospital Stay
Time Frame: From surgery to discharge within 30 days
Length of hospital stay will be measured in days from the day of surgery until final disposition (discharge or death).
From surgery to discharge within 30 days
Paralytic Ileus
Time Frame: From surgery till hospital stay within 30 days postoperatively
Incidence of postoperative paralytic ileus defined as presence of abdominal distension with absence of bowel sounds on clinical examination (auscultation for at least one minute).
From surgery till hospital stay within 30 days postoperatively
Time to First Stool
Time Frame: From surgery till hospital stay until discharge within 30 days postoperatively
Time (in days) from surgery to passage of first postoperative stool, indicating return of bowel function.
From surgery till hospital stay until discharge within 30 days postoperatively
Time to First Fluid Diet
Time Frame: Postoperatively during hospital stay till discharge within 30 days postoperatively
Time (in days) from surgery to initiation and tolerance of first oral fluid intake postoperatively.
Postoperatively during hospital stay till discharge within 30 days postoperatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Recep Tayyip Erdogan Hospital Pakistan - Muzaffargarh

Investigators

  • Study Chair: Muhammad I Seerat, FCPS, Recep Tayyip Erdogan Hospital Muzaffargarh

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2025

Primary Completion (Actual)

October 30, 2025

Study Completion (Actual)

October 30, 2025

Study Registration Dates

First Submitted

June 10, 2026

First Submitted That Met QC Criteria

June 10, 2026

First Posted (Actual)

June 16, 2026

Study Record Updates

Last Update Posted (Actual)

June 16, 2026

Last Update Submitted That Met QC Criteria

June 10, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • U1111-1342-1146

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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