Applicability of Enhanced Recovery After Surgery Protocols in the Therapeutic Endoscopy Suite

Официальное название

Applicability of Enhanced Recovery After Surgery Protocols in the Therapeutic Endoscopy Suite: a Single-Center Randomized Prospective Study

Обзор

This study aims to investigate the impact of implementing ERAS protocols on patient outcomes in therapeutic endoscopy, focusing on patients undergoing ESD. Although considered a less invasive alternative to conventional surgical resection, ESD can still result in significant physiological stress, postoperative discomfort, and potential complications. By exploring the application of ERAS principles to therapeutic endoscopy and evaluating their effectiveness, this study aims to address the current lack of knowledge in this field and promote the adoption of ERAS principles in managing ESD patients. Ultimately, the goal is to assess if the implementation of the ERAS process in these therapeutic endoscopy procedures can reduce procedure-related complications, improve patient outcomes, and enhance after-procedural recovery.

Вмешательства

• Процедура ERAS protocols
  Enhanced Recovery After Surgery (ERAS) guidelines are evidence-based recommendations aimed at improving patient outcomes and reducing complications after surgery.

Первичные конечные точки

• Rate of ESD-related adverse events [Срок оценки: 48 hours after procedure]
• airway protection [Срок оценки: during procedure]

Вторичные конечные точки (5)

• Post-procedural Recovery [Срок оценки: 24-48 hours after procedure]
• Overall patient satisfaction [Срок оценки: 24-48 hours after procedure]
• Abdominal pain [Срок оценки: at 3 and 6 hours after endoscopy]
• Analgesic requirements [Срок оценки: in the 24 hours after ESD]
• PADSS: Post Anesthetic Discharge Scoring System (evaluated from 0 to 2, using: Vital signs, Activity and mental status, Pain, nausea and/or vomiting, Surgical bleeding, Intake and output) [Срок оценки: in the first 4 hours after ESD]

Критерии участия

Критерии включения

• All >18 years-old patients scheduled for ESD for any indication;
• Patients who were able to give informed written consent.

Критерии исключения

• \- Patients who were not able or refused to give informed written consent.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Поддерживающая терапия

Центры проведения

Италия · 1 центр

• Humanitas Research Hospital — Milan

Публикации

• Ficari F, Borghi F, Catarci M, Scatizzi M, Alagna V, Bachini I, Baldazzi G, Bardi U, Benedetti M, Beretta L, Bertocchi E, Caliendo D, Campagnacci R, Cardinali A, Carlini M, Cascella M, Cassini D, Ciotti S, Cirio A, Coata P, Conti D, DelRio P, Di Marco C, Ferla L, Fiorindi C, Garulli G, Genzano C, Guercioni G, Marra B, Maurizi A, Monzani R, Pace U, Pandolfini L, Parisi A, Pavanello M, Pecorelli N, PMID 32003714
• Ahmed J, Khan S, Lim M, Chandrasekaran TV, MacFie J. Enhanced recovery after surgery protocols - compliance and variations in practice during routine colorectal surgery. Colorectal Dis. 2012 Sep;14(9):1045-51. doi: 10.1111/j.1463-1318.2011.02856.x. PMID 21985180
• Wang Y, Zhu Z, Li H, Sun Y, Xie G, Cheng B, Ji F, Fang X. Effects of preoperative oral carbohydrates on patients undergoing ESD surgery under general anesthesia: A randomized control study. Medicine (Baltimore). 2019 May;98(20):e15669. doi: 10.1097/MD.0000000000015669. PMID 31096498
• Li J, Kang G, Liu T, Liu Z, Guo T. Feasibility of Enhanced Recovery After Surgery Protocols Implemented Perioperatively in Endoscopic Submucosal Dissection for Early Gastric Cancer: A Single-Center Retrospective Study. J Laparoendosc Adv Surg Tech A. 2023 Jan;33(1):74-80. doi: 10.1089/lap.2022.0269. Epub 2022 Jun 20. PMID 35723625
• Wang Y, Zhou D, Xiong W, Ge S. Modified protocol for Enhanced Recovery After Surgery is beneficial for achalasia patients undergoing peroral endoscopic myotomy: a randomized prospective trial. Wideochir Inne Tech Maloinwazyjne. 2021 Dec;16(4):656-663. doi: 10.5114/wiitm.2021.104013. Epub 2021 Mar 1. PMID 34950259
• Greco M, Capretti G, Beretta L, Gemma M, Pecorelli N, Braga M. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials. World J Surg. 2014 Jun;38(6):1531-41. doi: 10.1007/s00268-013-2416-8. PMID 24368573
• Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, Rockall TA, Young-Fadok TM, Hill AG, Soop M, de Boer HD, Urman RD, Chang GJ, Fichera A, Kessler H, Grass F, Whang EE, Fawcett WJ, Carli F, Lobo DN, Rollins KE, Balfour A, Baldini G, Riedel B, Ljungqvist O. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS(R)) Society Recommen PMID 30426190
• ASGE Standards of Practice Committee; Early DS, Lightdale JR, Vargo JJ 2nd, Acosta RD, Chandrasekhara V, Chathadi KV, Evans JA, Fisher DA, Fonkalsrud L, Hwang JH, Khashab MA, Muthusamy VR, Pasha SF, Saltzman JR, Shergill AK, Cash BD, DeWitt JM. Guidelines for sedation and anesthesia in GI endoscopy. Gastrointest Endosc. 2018 Feb;87(2):327-337. doi: 10.1016/j.gie.2017.07.018. Epub 2018 Jan 3. No ab PMID 29306520

Идентификаторы

NCT: NCT06409676 · ERATE ID. 3764

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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