Neoplasms

All Conditions

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Rare Diseases

Carcinoma

Carcinoma, Renal Cell

Adenocarcinoma

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Kidney Neoplasms

Urologic Neoplasms

Urogenital Neoplasms

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Kidney Diseases

Urologic Diseases

Male Urogenital Diseases

Renal Cell Carcinoma

Clear Cell Renal Cell Carcinoma

All Drugs and Chemicals

Imidacloprid

undergoing a minimally invasive nephrectomy, eligible to an Enhanced Recovery After Surgery Program.

practice of an enhanced recovery after surgery program, according to the international reviews of literature and national recommendation

enhanced recovery after surgery program

Gilles Lebuffe, MD,PhD

Shorten the time spent in the hospital (hospitalization duration) by optimizing the pre, per and postoperative care is of major medical and economic importance.

Minimally invasive surgery allows a faster recovery than open surgery. However, we need to ensure an early and secure return to normality in order to discharge patients safely from the hospital.

Clinical and biological parameters need to be controlled post-surgery.

This work is going to evaluate the efficacity of a fast - recovery program with incoming patients receiving minimally invasive surgery (laparoscopic or robotic) of partial and total nephrectomy.

The implementation of a medical and surgical fast-recovery program could

* Lower the average duration of stay in hospital (at least by 1 day) with no increase of morbidity
* Insure the absence of complications after 6 months home

Prospective study of a fast recovery program evaluating the impact on the hospitalization length and the incidence of re-hospitalization for complications for 60 patients undergoing a minimally invasive nephrectomy.

The cohort will beneficiate of an extra preoperative information about the enhanced recovery after surgery program, they will benefit from a strategie of low morphine consumption during the per end post operative phase, they should need no bladder or abdominal drainage, they're encourage to eat and drink a few hours after surgery, the intravenous fluid is interrupted as early as possible, and the patients are encourage to sit, stand up and get dressed as soon as they are capable.

A form completed by the patient registers their every day capabilities to eat, drink, move, and their limitations due to pain, dizziness, and nausea. Their bowel and urine transit are also registered. This form is complete until discharge from the hospital.

Their laboratory test is monitored to identify kidney insufficiency or anemia and compared with the preoperative laboratory tests.

The hospital discharge is allowed after medical and surgical criteria are met in both groups.

A surgical evaluation is planned a week, one month, and 6 months after surgery with laboratory exams.

1 month after the discharge, a satisfaction questionnaire is filled up by the patient, answered by telephone.

At the 6 months post operative consultation, a questionnaire about chronic pain is submitted. If the patient is eligible, a chronic pain consultation is further organized.

The result will be compared to those of a retrospective cohort (+/- 60 patients) with no enhanced recovery after surgery program.

Advantage of a Fast-recovery Protocol for Minimally Invasive Kidney Surgery

Satisfaction numerical scale from 0 to 10 : with 0 being the least satisfied possible to 0 being the most satisfied possible

The questionnaire is made of 10 binnaire questions with "yes" or "no" answers, yes standing for 1 point, no standing for 0 point. The minimum score is 0 reflecting the absence of neuropathic pain, the maximum score is 10 reflecting the most intense neuropathic pain possible. The test is positive for the diagnosis of post surgical neuropathic pain at a score of 4 and above.

University Hospital, Lille

Digestive System Diseases

Stomach Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Stomach Diseases

Stomach Cancer

Patients who enroll in this arm are supplied a liquid diet one day before surgery without bowel preparation.

After gastric cancer surgery, they start sips of water on postoperative first day, and they are discharged once they exhibit at least three times soft diet without specific complaint and had normal clinical status and physical examination.

The patients are started on sips of water on the first postoperative day. If they are tolerable, a liquid diet is started on the second postoperative day, and a soft diet on a third postoperative day for them. We have a plan to discharge the patients on the fourth postoperative day if they exhibit at least three times soft diet without specific complaint and had normal clinical status and physical examination.

Early recovery

Hoon Hur, Prof.

Hoon Hur, prof.

Sang-Uk Han, prof.

Sang-Uk Han, Professor

Cheul Soo Byun, Instructor

Study preparation

* To progress this prospective study, the investigators analyzed the retrospective data of 426 patients who had been managed with conventional critical pathway after gastric cancer surgery during last 1 year.
* Through this retrospective analysis, we decided the inclusion criteria which showed significantly the lower complication rate and shorter hospital stay.

Method for Prospective study

* Patients who enroll in this prospective study are administered and are supplied a liquid diet one day before surgery without bowel preparation.
* After gastric cancer surgery, they start sips of water on postoperative first day, and they are discharged once they exhibit at least three times soft diet without specific complaint and had normal clinical status and physical examination.

Enrollment of patients

* Before the patients are enrolled in this study, they give us informed consents.
* A liquid diet is supplied beginning from the morning of the day prior to operation to the midnight.

Operation and postoperative management

* All procedures are approached by laparoscopic surgery, and partial gastrectomy with lymph node dissection are performed.
* The patients who are considered to be difficult to progress early oral feeding in surgical field are excluded from the study.
* Nasogastric tube is not applied to patients.
* Postoperative pain is managed by non-opioid pain killer.
* The patients are started on sips of water on the first postoperative day.
* If they are tolerable, a liquid diet is started on the second postoperative day, and a soft diet on a third postoperative day for them.
* We have a plan to discharge the patients on the fourth postoperative day if they exhibit at least three times soft diet without specific complaint and had normal clinical status and physical examination.

Evaluation of patients

- The patients are followed up to 30 days after discharge from hospital, and we check whether they are tolerable without any compliant and are readmitted.

Early Recovery After Gastric Cancer Surgery

Prospective Clinical Study for Early Recovery After Gastric Cancer Surgery

It is defined as the proportion of dropped patients from 4 days critical pathway

It is defined as the change of pain scale after surgery

It is defined the complications after surgery

It will defined as the death case during 30 days after surgery

It is defined as the time to first flatus and recovery of bowel activity after surgery

JW Pharmaceutical

Ajou University School of Medicine

Assistant Professor

Patients who receive ERAS program after gastric cancer surgery

The main 18 elements of ERAS program included are described in detail in the brief summary of the study

Enhanced recovery after surgery

Young-Kyu Park, MD, PhD

The purpose of this study is to prospectively evaluate the overall compliance to the enhanced recovery after surgery (ERAS) program in patients undergoing gastric cancer surgery.

The feasibility and effectiveness of ERAS program for various major surgical procedures have been well studies in the literature. However, ERAS program has not been widely accepted for patients undergoing gastric cancer surgery because of the paucity of evidence about its feasibility and efficacy. In this study, we developed ERAS program for gastric cancer surgery, based on the systemic review about perioperative cares. The main elements of ERAS program includes: 1preoperative patient education, 2)no preoperative bowel preparation, 3) provision of normal diet until the night before surgery, 4)carbohydrate rich drink 2 hrs before surgery, 5)epidural anesthesia for pain control, 6) local wound anesthetic infiltration for pain control, 7)no routine abdominal drain, 8)no naso-gastric tube insertion, 9)intraoperative antibiotics, 10)thromboprophylaxis using intermittent pneumatic compression device, 11)intraoperative normothermia using warm air blanket, 12)low oxygen supply during immediate postoperative period, 13)restrictive postoperative fluid administration, 14)early postoperative oral diet, 15)early active ambulation, 16)early removal of the urinary catheter, 17)patient education before discharge, and 18)hospital discharge based on discharge criteria.

The aim of study is to evaluate the compliance to these main elements of ERAS program in patients undergoing gastric cancer surgery.

Previously reported data about ERAS program for colon surgery reported overall compliance as about 65%. Considering that this is a single center study, we expected overall compliance rate of 70%. Therefore, the sample size of 173 patients was calculated based on this expected compliance rate, with permitted error of 95% confidence interval of 14%.

Compliance to ERAS After Gastric Surgery

Phase II Study Evaluating the Compliance to the Enhanced Recovery After Surgery (ERAS) Program in Patients Undergoing Gastrectomy for Gastric Carcinoma

Patient's compliance to the 18 main elements of ERAS program

Postoperative complications means any complications occured within 90 days after operation, and will be assessed based on the predefined definition and severity of postoperative complication of our institution.

The length of hospital stay means the duration from the operation until hospital discharge.

Any death related to surgery within 90 days after surgery

Chonnam National University Hospital

Professor, Department of Gastroenterologic Surgery

Colorectal Neoplasms

Intestinal Neoplasms

Colonic Diseases

Intestinal Diseases

Rectal Diseases

Central Nervous System Depressants

Anesthetics

standard surgery and Standard care after surgery

Laparoscopic colorectal surgery with rehabilitation program

Rehabilitation program including specific anesthetic drugs, post operative fast track recovery (early diet, mobilisation, antalgics)

Rehabilitation program

Rehabilitation program improves operative results following conventional open colorectal surgery. Very few data are available on such program in laparoscopic colorectal surgery.

The aim is to assess rehabilitation program in laparoscopic colorectal surgery in terms of 30 days peri operative complications

Benefit of Rehabilitation Program in Colorectal Surgery

Benefit of Rehabilitation Program in Colorectal Laparoscopic Surgery

Post operative morbidity at 30 days according to DINDO CLAVIEN classification (grade I to IV)

Mortality according to DINDO CLAVIEN classification (grade V)

Initial hospital stay and possible unscheduled readmissions

Global (SF36) and specific (GIQLI) quality of life Preoperative and at 1, 3, 6 months

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Advantage of a Fast-recovery Protocol for Minimally Invasive Kidney Surgery	NCT04601129	Renal Cell Carc...	enhanced recove...	18 Years - 75 Years	University Hospital, Lille
Early Recovery After Gastric Cancer Surgery	NCT01642953	Fasting Malignant Neopl...	Early recovery	- 65 Years	Ajou University School of Medicine
Compliance to ERAS After Gastric Surgery	NCT01653496	Stomach Neoplas...	Enhanced recove...	18 Years - 70 Years	Chonnam National University Hospital
Benefit of Rehabilitation Program in Colorectal Surgery	NCT01609361	Colorectal Canc...	Rehabilitation ...	18 Years -	Assistance Publique - Hôpitaux de Paris
Advantage of a Fast-recovery Protocol for Minimally Invasive Kidney Surgery	NCT04601129	Renal Cell Carc...	enhanced recove...	18 Years - 75 Years	University Hospital, Lille
Compliance to ERAS After Gastric Surgery	NCT01653496	Stomach Neoplas...	Enhanced recove...	18 Years - 70 Years	Chonnam National University Hospital

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