Postoperative Outcomes Within an Enhanced Recovery After Surgery Protocol in Gastric Surgery for Cancer

NCT ID: NCT03865810

Last Updated: 2019-03-08

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

Total Enrollment

861 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-10-22

Study Completion Date

2020-03-22

Brief Summary

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Methods National audit of a 90-day prospective observational cohort in which postoperative complications will be analyzed at 30 days of follow-up in adult patients undergoing scheduled surgery for gastric resection for cancer with or without an intensified recovery program (ERAS : Enhanced Recovery after Surgery) with any level of protocol compliance (from 0-100%)

Research Locations Spanish Hospitals at the state level where these surgical interventions are performed on a regular basis.

Objectives To determine the incidence of postoperative complications per patient and procedure, regardless of the degree of adherence to ERAS protocols and its impact on the hospital stay and postoperative complications including 30-day mortality.

Sample Size For an alpha error of 5% (95% confidence) and an accuracy of 3% and estimating a number of patients with complications of 28%, the sample size calculation yields 861 patients, although the final sample size it may be smaller depending on the proportion of complications detected.

Inclusion criteria Patients older than 18 years who are going to undergo surgery for gastric resection surgery due to cancer regardless of their affiliation to an ERAS intensified recovery program and the compliance level of the protocol (0-100%)

Statistical analysis Continuous variables will be described as mean and standard deviation, if it is a normal distribution, or median and interquartile range, if they are not normally distributed. Comparisons of continuous variables will be performed by one-way ANOVA or the Mann-Whitney test, as appropriate. A univariate analysis will be performed to test the factors associated with postoperative complications, hospital stay and death in the hospital. Univariate analyzes and hierarchical multivariate logistic regression models will be constructed to identify factors associated independently with these results and to adjust for differences in confounding factors. The factors will be introduced in the models based on their relationship with the univariate result (p \<0.05), the biological plausibility and the low rate of missing data.

Detailed Description

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The results of this study will allow to identify, on the one hand, the type of patients presenting postoperative complications and, on the other hand, to identify those items of the ERAS protocols that are independently associated with a reduction in postoperative complications and hospital stay, which will allow to focus the perioperative efforts in those items that actually improve the postoperative outcomes.

Aim 1 will establish the number of patients developing predefined postoperative complications within 30 days of surgery in adult patients undergoing scheduled surgery for gastric resection for cancer with any compliance of an ERAS protocol (including patients with 0 compliance). This will allow us to determine the actual impact of these protocols.

Aim 2 will allow us to know the type of predefined complication presented by the patients included in the ERAS protocols and in patients undergoing colorectal surgery; This will allow, on the one hand, to have a starting point for future clinical trials, and, on the other hand, to focus efforts to avoid these complications.

Aim 3 will allow us to identify those perioperative items of ERAS protocols that are actually associated with a decrease in postoperative complications.

The proposed study will establish a real view of the number of patients presenting postoperative complications that will overcome the limitations of available retrospective studies and provide greater insight into the items of the protocols that are associated with decreased complications; on the other hand, the investigator's hypothesis is that the number of patients who develop predefined postoperative complications within 30 days of surgery decreases as there is greater compliance with the predefined ERAS protocol items

Conditions

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Perioperative Care Postoperative Complications Gastric Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Gastric Surgery

Adult patients undergoing elective gastric surgery for cancer

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* All patients over 18 years of age undergoing gastric resection surgery due to cancer within or not of an intensified recovery program (ERAS) with any level of compliance with the protocol (from 0-100%).

Exclusion Criteria

* Patients undergoing emergency surgery

* Endoscopic procedures
* Non-oncological gastric surgery
* Patients who refuse to participate
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Grupo Español de Rehabilitación Multimodal

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Javier Ripollés-Melchor

Role: STUDY_CHAIR

Infanta Leonor University Hospital, Madrid, Spain

Marcos Bruna Esteban

Role: STUDY_CHAIR

Hospital General Universitario de Valencia, Spain

José M Ramírez Rodríguez

Role: STUDY_CHAIR

Lozano Blesa University Hospital, Zaragoza, Spain

César Aldecoa

Role: STUDY_CHAIR

Hospital Universitario Río Hortega, Valladolid Spain

Ane Abad Motos

Role: STUDY_CHAIR

Infanta Leonor University Hospital, Madrid, Spain

Peter Vorwald

Role: STUDY_DIRECTOR

Hospital Universitario Fundación Jiménez Díaz. Madrid, Spain

Gloria Crespo

Role: STUDY_DIRECTOR

Infanta Leonor University Hospital, Madrid, Spain

Carlos Ferrando Ortolá

Role: STUDY_DIRECTOR

Hospital Clinic of Barcelona

Joaquín Rodríguez Santiago

Role: STUDY_DIRECTOR

Hospital Mutua Teresa, Spain

José A García Erce

Role: STUDY_DIRECTOR

Servicio Navarro de Salud - Osasunbidea. Pamplona, Spain

Locations

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Hospital Virgen de los Lirios de Alcoy

Alcoy, Alicante, Spain

Site Status

Hospital General Universitario de Elche

Elche, Alicante, Spain

Site Status

Hospital Don Benito-Villanueva de la Serena

Don Benito-Villanueva de La Serena, Badajoz, Spain

Site Status

Hospital de Mérida

Mérida, Badajoz, Spain

Site Status

Hospital de Igualada

Igualada, Barcelona, Spain

Site Status

Hospital Universitario Parc Tauli

Sabadell, Barcelona, Spain

Site Status

Hospital de Sant Joan Despí Moisès Broggi

Sant Joan d'Espi, Barcelona, Spain

Site Status

Fundación Hospital del Espíritu Santo

Santa Coloma de Gramanet, Barcelona, Spain

Site Status

Hospital Mútua Terrassa

Terrassa, Barcelona, Spain

Site Status

Hospital Universitario de Vic

Vic, Barcelona, Spain

Site Status

Hospital Universitario de Cruces

Barakaldo, Bizkaia, Spain

Site Status

Hospital General Universitario de Castellón

Castellon, Castellón, Spain

Site Status

Hospital Comarcal de Vinaroz

Vinaròs, Castellón, Spain

Site Status

Complejo Hospitalario Universitario de A Coruña

A Coruña, Coruña, Spain

Site Status

Hospital Universitario Puerta del Mar

Cadiz, Cádiz, Spain

Site Status

Complejo Asistencial Universitario de León

León, León, Spain

Site Status

Hospital Universitario Príncipe de Asturias

Alcalá de Henares, Madrid, Spain

Site Status

Hospital Universitario Fundación Alcorcón

Alcorcón, Madrid, Spain

Site Status

Hospital Universitario de Fuenlabrada

Fuenlabrada, Madrid, Spain

Site Status

Hospital Universitario Getafe

Getafe, Madrid, Spain

Site Status

Hospital Universitario Puerta de Hierro

Majadahonda, Madrid, Spain

Site Status

Hospital Rey Juan Carlos

Móstoles, Madrid, Spain

Site Status

Hospital Universitario de Móstoles

Móstoles, Madrid, Spain

Site Status

Hospital Universitario Quirón Madrid

Pozuelo de Alarcón, Madrid, Spain

Site Status

Hospital Universitario de Torrejón

Torrejón de Ardoz, Madrid, Spain

Site Status

Hospital Comarcal de Inca

Inca, Mallorca, Spain

Site Status

Hospital de Manacor

Manacor, Mallorca, Spain

Site Status

Hospital Rafael Méndez

Lorca, Murcia, Spain

Site Status

Hospital Costa del Sol

Marbella, Málaga, Spain

Site Status

Complejo Hospitalario de Navarra

Pamplona, Navarre, Spain

Site Status

Hospital Universitario Central de Asturias

Oviedo, Principality of Asturias, Spain

Site Status

Hospital Nuestra Señora del Prado

Talavera de la Reina, Toledo, Spain

Site Status

Hospital de Manises

Manises, Valencia, Spain

Site Status

Hospital General Universitario de Alicante

Alicante, , Spain

Site Status

Hospital Clínic Universitat de Barcelona

Barcelona, , Spain

Site Status

Hospital Universitario Sant Pau

Barcelona, , Spain

Site Status

Hospital Universitario Vall d´Hebrón

Barcelona, , Spain

Site Status

Hospital Universitario de Burgos

Burgos, , Spain

Site Status

Hospital General Universitario de Ciudad Real

Ciudad Real, , Spain

Site Status

Hospital Universitario de Guadalajara

Guadalajara, , Spain

Site Status

Hospital Universitario de Gran Canaria Doctor Negrín

Las Palmas, , Spain

Site Status

Hospital Universitario Insular de Gran Canaria

Las Palmas de Gran Canaria, , Spain

Site Status

Hospital Universitario Arnau de Vilanova

Lleida, , Spain

Site Status

Hospital Clínico San Carlos

Madrid, , Spain

Site Status

Hospital de La Princesa

Madrid, , Spain

Site Status

Hospital General Universitario Gregorio Marañón

Madrid, , Spain

Site Status

Hospital Universitario 12 de Octubre

Madrid, , Spain

Site Status

Hospital Universitario La Paz

Madrid, , Spain

Site Status

Hospital Universitario Ramón y Cajal

Madrid, , Spain

Site Status

Hospital General Universitario José María Morales Messeguer

Murcia, , Spain

Site Status

Hospital Reina Sofía

Murcia, , Spain

Site Status

Complejo Hospitalario y Universitario de Pontevedra

Pontevedra, , Spain

Site Status

Complejo Hospitalario de Salamanca

Salamanca, , Spain

Site Status

Hospital Universitario Marqués de Valdecilla

Santander, , Spain

Site Status

Complejo Asistencial de Segovia

Segovia, , Spain

Site Status

Hospital Universitario Virgen de Valme

Seville, , Spain

Site Status

Hospital Universitario Virgen Macarena

Seville, , Spain

Site Status

Complejo Hospitalario de Toledo

Toledo, , Spain

Site Status

Hospital Clínico Universitario de Valencia

Valencia, , Spain

Site Status

Hospital General Universitario de Valencia

Valencia, , Spain

Site Status

Hospital Universitario La Fe

Valencia, , Spain

Site Status

Hospital Clínico de Valladolid

Valladolid, , Spain

Site Status

Hospital Universitario Río Hortega

Valladolid, , Spain

Site Status

Hospital Universitario de Álava

Vitoria-Gasteiz, , Spain

Site Status

Complejo Asistencial de Zamora

Zamora, , Spain

Site Status

Hospital Clínico Universitario Lozano Blesa

Zaragoza, , Spain

Site Status

Countries

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Spain

Central Contacts

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Javier Ripollés-Mellchor

Role: CONTACT

34 649337762

José M Ramírez Rodríguez

Role: CONTACT

34 649337762

References

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Ripolles-Melchor J, Abad-Motos A, Bruna-Esteban M, Garcia-Nebreda M, Otero-Martinez I, Abdel-Lah Fernandez O, Tormos-Perez MP, Paseiro-Crespo G, Garcia-Alvarez R, A Mayo-Ossorio M, Zugasti-Echarte O, Nespereira-Garcia P, Gil-Gomez L, Logrono-Ejea M, Risco R, Parreno-Manchado FC, Gil-Trujillo S, Benito C, Jerico C, De-Miguel-Cabrera MI, Ugarte-Sierra B, Barragan-Serrano C, Garcia-Erce JA, Munoz-Hernandez H, Rio-Fernandez SD, Herrero-Bogajo ML, Espinosa-Moreno AM, Concepcion-Martin V, Zorrilla-Vaca A, Vaquero-Perez L, Mojarro I, Llacer-Perez M, Gomez-Viana L, Fernandez-Martin MT, Abad-Gurumeta A, Ferrando-Ortola C, Ramirez-Rodriguez JM, Aldecoa C; POWER Study Investigators Group. Association between use of enhanced recovery after surgery protocols and postoperative complications after gastric surgery for cancer (POWER 4): a nationwide, prospective multicentre study. Cir Esp (Engl Ed). 2023 Oct;101(10):665-677. doi: 10.1016/j.cireng.2023.04.011. Epub 2023 Apr 23.

Reference Type DERIVED
PMID: 37094777 (View on PubMed)

Abad-Motos A, Ripolles-Melchor J, Bruna-Esteban M, Ferrando-Ortola C, Paseiro-Crespo G, Abad-Gurumeta A, Garcia-Erce JA, Jerico C, Ramirez JM, Aldecoa C. Postoperative Outcomes Within an Enhanced Recovery after surgery protocol in gastric surgery for cancer (POWER.4): Study protocol for a prospective, multicentre, observational cohort study. Rev Esp Anestesiol Reanim (Engl Ed). 2020 Mar;67(3):130-138. doi: 10.1016/j.redar.2019.10.004. Epub 2019 Nov 22. English, Spanish.

Reference Type DERIVED
PMID: 31767197 (View on PubMed)

Other Identifiers

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REDGERM05

Identifier Type: -

Identifier Source: org_study_id

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