The Fast Track Rehabilitation in Thoracic Surgery

NCT ID: NCT02831140

Last Updated: 2016-07-13

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

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-31

Study Completion Date

2018-06-30

Brief Summary

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This prospective, randomized study is designed to evaluate the effectiveness of postoperative care pathway using the Fast Track Rehabilitation protocol (FTR) in comparison with the traditional postoperative care.

In order to conduct this study, patients having a thoracic surgery will be randomly attributed to FTR protocol group or control group.

Detailed Description

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Traditionally, patients who underwent thoracic surgery have been treated with a classical protocol which include; bed rest, ambulation prohibited for 24-48 hours and starvation for several postoperative days till the recovery of bowel. Some studies reported the efficacy of early rehabilitation protocols or FTR protocols in thoracic surgery to reduce postoperative complications and to minimize hospital stay. But these studies are few and retrospective. Prospective randomized trials focuses based on the "fast track regimen" or medical fast track that interest only on the medical component .

This prospective, randomized study is designed to evaluate the effectiveness of postoperative care pathway using FTR protocol in comparison with the traditional postoperative care.

In order to conduct this study, patients having a thoracic surgery will be randomly attributed to FTR protocol group or control group.

Conditions

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Thoracic Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Common arm : for both groups :

* In preoperative phase
* In peroperative phase
* In postoperative phase

Group Type OTHER

commun interventions

Intervention Type BEHAVIORAL

* In preoperative phase: stopping smoking at least 2 weeks, hospitalization and balanced alimentation one day before the surgery.
* In peroperative phase : no use of benzodiazepines in the anesthesia , selective intubation , maintaining vital parameters as normal and using a mini invasive surgical approach ( video thoracoscopy , video assisted thoracoscopy , thoracotomy with preservation of the posterior muscles of the chest wall

, preservation of Serratus anterior and the front part of Latissimus Dorsi ).
* In postoperative phase : Immediate extubation ( less than 30 minutes from the surgery end) , peridural or paravertebral or intercostal block analgesia , no use of abusive antibiotic , all analgesic drugs are permitted if there are no contraindications and physiotherapy from the 6th hour.

FTR protocol group (A)

A. Experimental : FTR protocol group :

Early exercises after a thoracic surgery : removing urinary probe and all catheters as well as alimenting .

Group Type EXPERIMENTAL

Early exercises

Intervention Type BEHAVIORAL

In postoperative phase:

Early exercises: within the first hour ;setting a half bed position, deep breathing and coughing . In the second hour, curbing vagal malaise and performing relaxation movements. In the third hour, walking about 20 to 30 minutes.

Removing urinary probe and all catheters.

Intervention Type BEHAVIORAL

In postoperative phase : Removing urinary probe and all catheters.

Early alimentation

Intervention Type BEHAVIORAL

In postoperative phase :Early alimentation: in the first hour to the second hour .

Control group (B)

Traditional, conventional care group with first get up and alimentation permission in 24 hours at the postoperative.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Early exercises

In postoperative phase:

Early exercises: within the first hour ;setting a half bed position, deep breathing and coughing . In the second hour, curbing vagal malaise and performing relaxation movements. In the third hour, walking about 20 to 30 minutes.

Intervention Type BEHAVIORAL

Removing urinary probe and all catheters.

In postoperative phase : Removing urinary probe and all catheters.

Intervention Type BEHAVIORAL

Early alimentation

In postoperative phase :Early alimentation: in the first hour to the second hour .

Intervention Type BEHAVIORAL

commun interventions

* In preoperative phase: stopping smoking at least 2 weeks, hospitalization and balanced alimentation one day before the surgery.
* In peroperative phase : no use of benzodiazepines in the anesthesia , selective intubation , maintaining vital parameters as normal and using a mini invasive surgical approach ( video thoracoscopy , video assisted thoracoscopy , thoracotomy with preservation of the posterior muscles of the chest wall

, preservation of Serratus anterior and the front part of Latissimus Dorsi ).
* In postoperative phase : Immediate extubation ( less than 30 minutes from the surgery end) , peridural or paravertebral or intercostal block analgesia , no use of abusive antibiotic , all analgesic drugs are permitted if there are no contraindications and physiotherapy from the 6th hour.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* All patients who have lung surgery during the study period after their consents are included.

Exclusion Criteria

* Patients who have bad general state are unable to move or require a wake in the resuscitation.
* The Patients with thoracic soft tissue surgery.
* patients having mediastinoscopy, surgery of the chest wall or mediastinum.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Community medicine department -Habib Bourguiba University Hospital

UNKNOWN

Sponsor Role collaborator

Habib Bourguiba University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Abdessalem Hentati

Thoracic surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Imed Frihka, Professor

Role: STUDY_DIRECTOR

Cardiovascular and thoracic surgery department - Habib Bourguiba University Hospital

Locations

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Cardiovascular and thoracic surgery department - Habib Bouguiba University Hospital

Sfax, , Tunisia

Site Status RECRUITING

Countries

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Tunisia

Central Contacts

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Ahmed Ben Ayed, Resident

Role: CONTACT

23935354 ext. 00216

References

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Muehling BM, Halter GL, Schelzig H, Meierhenrich R, Steffen P, Sunder-Plassmann L, Orend KH. Reduction of postoperative pulmonary complications after lung surgery using a fast track clinical pathway. Eur J Cardiothorac Surg. 2008 Jul;34(1):174-80. doi: 10.1016/j.ejcts.2008.04.009. Epub 2008 May 19.

Reference Type BACKGROUND
PMID: 18490173 (View on PubMed)

Sokouti M, Aghdam BA, Golzari SE, Moghadaszadeh M. A comparative study of postoperative pulmonary complications using fast track regimen and conservative analgesic treatment: a randomized clinical trial. Tanaffos. 2011;10(3):12-9.

Reference Type BACKGROUND
PMID: 25191370 (View on PubMed)

Padilla Alarcon J, Penalver Cuesta JC. Experience with lung resection in a fast-track surgery program. Arch Bronconeumol. 2013 Mar;49(3):89-93. doi: 10.1016/j.arbres.2012.09.011. Epub 2012 Dec 13. English, Spanish.

Reference Type RESULT
PMID: 23245565 (View on PubMed)

Das-Neves-Pereira JC, Bagan P, Coimbra-Israel AP, Grimaillof-Junior A, Cesar-Lopez G, Milanez-de-Campos JR, Riquet M, Biscegli-Jatene F. Fast-track rehabilitation for lung cancer lobectomy: a five-year experience. Eur J Cardiothorac Surg. 2009 Aug;36(2):383-91; discussion 391-2. doi: 10.1016/j.ejcts.2009.02.020. Epub 2009 Mar 26.

Reference Type RESULT
PMID: 19324571 (View on PubMed)

Other Identifiers

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FTRCCVTSFAX

Identifier Type: -

Identifier Source: org_study_id

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