Electroacupuncture Versus Fast-track Perioperative Program for Laparoscopic Colorectal Surgery
A Randomized Clinical Trial of Electroacupuncture Versus Fast-track Perioperative Program for Reducing Duration of Postoperative Ileus and Hospital Stay After Laparoscopic Colorectal Surgery
Background: Our previous study demonstrated that electroacupuncture at Zusanli, Sanyinjiao, Hegu, and Zhigou reduces the duration of postoperative ileus and hospital stay after laparoscopic colorectal surgery within a traditional perioperative care setting. Recent evidence also suggested that a 'fast-track' perioperative program may help accelerate recovery after colorectal surgery. As electroacupuncture is simpler to implement and less labor intensive, it may be the preferred adjunct therapy if it is proven to be noninferior to fast-track program in reducing the duration of postoperative ileus and hospital stay after laparoscopic colorectal surgery.
Objectives: To compare the efficacy of electroacupuncture and fast-track program in reducing the duration of postoperative ileus and hospital stay after laparoscopic colorectal surgery.
Design: Prospective, randomized, noninferiority trial.
Subjects: One hundred sixty-four consecutive patients undergoing elective laparoscopic resection of colonic and upper rectal cancer will be recruited.
Interventions: Patients will be randomly allocated to receive either: (A) electroacupuncture with traditional perioperative care; or (B) fast-track program without acupuncture.
Outcome measures: Primary outcome: time to defecation. Secondary outcomes: duration of hospital stay, time of first passing flatus, time to resume diet, pain scores, analgesic requirement, morbidity, and medical costs.
Conclusions: This study will determine if electroacupuncture is noninferior to fast-track program in reducing the duration of postoperative ileus and hospital stay after laparoscopic colorectal surgery. Electroacupuncture may be the preferred perioperative adjunct therapy to laparoscopic colorectal surgery because it is simpler to implement and less labor intensive than fast-track program.
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Studientyp
Einschreibung (Voraussichtlich)
Phase
- Phase 3
Kontakte und Standorte
Studienorte
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Hong Kong, China
- Rekrutierung
- Prince of Wales Hospital, the Chinese University of Hong Kong
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Unterermittler:
- Tony WC Mak, MD
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Kontakt:
- Tony WC Mak, MD
- Telefonnummer: (852) 2632 1495
- E-Mail: tonymak@surgery.cuhk.edu.hk
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- Consecutive patients undergoing elective laparoscopic resection of colonic and upper rectal cancer
- Age of patients between 18 and 80 years
- Patients with American Society of Anesthesiologists (ASA) grading I-II
- Patients with no severe physical disability
- Patients who require no assistance with the activities of daily living
- Informed consent available
Exclusion Criteria:
- Patients undergoing laparoscopic low anterior resection with total mesorectal excision, abdominoperineal resection, or total/proctocolectomy
- Patients with planned stoma creation
- Patients undergoing emergency surgery
- Patients with evidence of peritoneal carcinomatosis
- Patients with previous history of midline laparotomy
- Patients who are expected to receive epidural opioids for postoperative pain management
- Patients with cardiac pacemaker
- Patients who are allergic to the acupuncture needles
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
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Experimental: Electroacupuncture
Bilateral acupoints relevant to the treatment of abdominal pain, 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.
Electric stimulation at a frequency of 50 Hz will be employed to the acupuncture needles.
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Aktiver Komparator: Fast-track program
The design of this program is based on the consensus between our surgeons, anesthetists, physiotherapists, dietitians, and nurses, who have reviewed the relevant literature and made appropriate adjustments to suit the local situation.
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Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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Zeit zum Stuhlgang
Zeitfenster: Bis zu 1 Monat
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Gemessen in Stunden, vom Ende der laparoskopischen Operation bis zum ersten beobachteten Stuhlgang.
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Bis zu 1 Monat
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Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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Zeitpunkt des ersten von den Patienten gemeldeten Blähungen
Zeitfenster: Bis zu 1 Monat
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Bis zu 1 Monat
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Zeit, in der die Patienten feste Nahrung vertrugen
Zeitfenster: Bis zu 1 Monat
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Bis zu 1 Monat
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Zeit, selbstständig zu gehen
Zeitfenster: Bis zu 1 Monat
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Bis zu 1 Monat
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Wiederaufnahmerate
Zeitfenster: Bis zu 1 Monat
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Bis zu 1 Monat
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Total postoperative hospital stay
Zeitfenster: Up to 1 month
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Including hospital stay of patients who are readmitted within 30 days after surgery.
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Up to 1 month
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Pain scores on visual analog scale
Zeitfenster: Up to 1 month
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From 0 which implies no pain at all, to 100 which implies the worst pain imaginable; assessed at 4, 12, 24, 48, and 72 hours after surgery.
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Up to 1 month
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Morbidity
Zeitfenster: Up to 1 month
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Up to 1 month
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Mortality
Zeitfenster: Up to 1 month
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Up to 1 month
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Quality of life
Zeitfenster: Up to 1 month
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Quality of life at 2 and 4 weeks after surgery, measured by SF-36, EORTC QLQ-C30 and QLQ-CR38 questionnaires
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Up to 1 month
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Mitarbeiter und Ermittler
Sponsor
Ermittler
- Hauptermittler: Simon S. M. Ng, MD, Chinese University of Hong Kong
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Voraussichtlich)
Studienabschluss (Voraussichtlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
- CRE-2013.009
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