Bowel Prep vs Non-Bowel Prep for Laparoscopic Colorectal Surgery

NCT ID: NCT00643084

Last Updated: 2008-03-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-05-31

Study Completion Date

2009-12-31

Brief Summary

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Research Question: Are anastomotic leak and surgical site infection rates equivalent in patients having laparoscopic bowel resections without bowel preparation vs those having bowel preparation?

Bowel preparation is a distressing and uncomfortable procedure for patients undergoing laparoscopic colorectal surgery, and also carries some risk of morbidity due to dehydration, electrolyte inbalance and possible infectious complications. If it is found that there is no difference between those patients who have preoperative bowel preps and those who do not have them, then we can save these patients this additional distress and risk at the time of their surgery.

Detailed Description

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Rationale: The question of whether a bowel prep is needed for colon resection in open surgery has been answered. However, in laparoscopic colorectal resections, it has not been prospectively investigated. Usually, reasons for still using a bowel prep in laparoscopic colon resections is that small instruments grasping the colon can tear it, and without a prep, stool spillage can result. As well, it may be difficult to manipulate a colon filled with stool, and difficult to identify lesions to be resected.

There are no previous randomized trials in the laparoscopic literature comparing laparoscopic colorectal resections with and without bowel preparations. There are a number of trials for open resections and one trial including both laparoscopic and open resections. Unfortunately this trial does not separate the data analysis for these two groups.

Primary and Secondary Outcomes: The question to be identified is whether anastomotic leaks, and surgical site infection rates are equivalent in patients having laparoscopic resections without bowel prep versus prepped patients.

Methodology: Once consent is obtained, the patients will be randomized into two groups-the study group who will eat a low residue diet prior to surgery and who will not undergo bowel preparation, or the control group who will complete the standard bowel preparation protocol. Both groups will have the scheduled surgery. All patients will be monitored for signs of anastomotic leak and surgical wound infection daily while in hospital and at routine follow up visits at 2 and 6 weeks postoperative. If these two complications are observed, standard treatment will be followed.

Conditions

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Anastomotic Leak Surgical Site Infection

Keywords

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Colorectal Bowel preparation Laparoscopic surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Caregivers Investigators Outcome Assessors

Study Groups

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1

patients will consume a low residue diet prior to surgery and have no routine bowel preparation

Group Type EXPERIMENTAL

low residue diet/no standard bowel preparation

Intervention Type PROCEDURE

low residue diet/no standard bowel preparation

2

standard bowel preparation

Group Type OTHER

standard bowel preparation

Intervention Type PROCEDURE

standard bowel preparation

Interventions

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low residue diet/no standard bowel preparation

low residue diet/no standard bowel preparation

Intervention Type PROCEDURE

standard bowel preparation

standard bowel preparation

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* patients undergoing elective laparoscopic colorectal resection for benign or malignant disease
* adults aged 18-85 years
* ASA 1-3

Exclusion Criteria

* contraindications to laparoscopic surgery
* patients undergoing procedures that result in creation of a stoma or ileostomy or loop ileostomy
* patients with pre-operative perforation of established infection
* patients who cannot understand the directions for bowel preparation or low residue diet
* patients with GI obstructions
* patients who will not be able to attend the followup appointments
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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McMaster University

OTHER

Sponsor Role collaborator

Hamilton Health Sciences Corporation

OTHER

Sponsor Role lead

Responsible Party

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McMaster University/St. Joseph's Heathcare Hamilton

Principal Investigators

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Margheta Cadeddu, MD

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Mehran Anvari, PhD MBBS

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Monali Misra, MD

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Forough Farrokhyar, PhD

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Locations

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McMaster University/St. Joseph's Healthcare Hamilton

Hamilton, Ontario, Canada

Site Status

Countries

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Canada

Central Contacts

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Dr. Margherita Cadeddu

Role: CONTACT

Phone: 905-522-1155

Email: [email protected]

Catherine Gill Pottruff

Role: CONTACT

Phone: 905-522-1155

Email: [email protected]

References

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Bucher P, Gervaz P, Soravia C, Mermillod B, Erne M, Morel P. Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg. 2005 Apr;92(4):409-14. doi: 10.1002/bjs.4900.

Reference Type BACKGROUND
PMID: 15786427 (View on PubMed)

Zmora O, Lebedyev A, Hoffman A, Khaikin M, Munz Y, Shabtai M, Ayalon A, Rosin D. Laparoscopic colectomy without mechanical bowel preparation. Int J Colorectal Dis. 2006 Oct;21(7):683-7. doi: 10.1007/s00384-005-0044-y. Epub 2005 Oct 18.

Reference Type BACKGROUND
PMID: 16231142 (View on PubMed)

Other Identifiers

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Bowel Prep

Identifier Type: -

Identifier Source: org_study_id