Evaluation of the Introduction of a Colorectal Bundle in Left Sided Colorectal Resections

NCT ID: NCT04550156

Last Updated: 2024-03-12

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

COMPLETED

Clinical Phase

NA

Total Enrollment

1141 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-01

Study Completion Date

2022-12-31

Brief Summary

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The complication rate in colorectal surgery is high and shows a large variance depending on the patient and the treating surgeon. The primary aim of the presented study is to evaluate the introduction of a colorectal bundle to reduce the complication rate in left sided colorectal resections. The colorectal bundle is a catalog of measures consisting of several items These are for example preoperative risk stratification, antibiotic and mechanical bowel preparation and preoperative showering. The primary endpoint will be the complication rate measured as the comprehensive clinical index (CCI) within 30 days. Investigators will include patients that undergo elective or emergency left sided colorectal surgery.

Detailed Description

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Conditions

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Colorectal Disorders Surgery--Complications Colorectal Cancer Anastomotic Leak Complication of Surgical Procedure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, randomised, multicenter trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Control Arm

Patients are treated according to current local standards

Group Type NO_INTERVENTION

No interventions assigned to this group

Colorectal Bundle Arm

Patients are treated according to the colorectal bundle

Group Type EXPERIMENTAL

Colorectal Bundle

Intervention Type PROCEDURE

1. Preoperative optimization of the nutritional status: Perform nutritional risk screening (NRS), measure albumin or prealbumin preoperatively and initiate nutritional support
2. Preoperative showering with an antiseptic agent
3. Administer preoperative antibiotic prophylaxis
4. Hair removal in the operative field with clippers
5. Peri-, intra-, and postoperative warming to maintain body temperature
6. Peri- and intraoperative glucose control
7. Usage of a wound protection device
8. Change of gloves and instruments after anastomosis
9. Anastomosis only with experienced senior surgeon present in theatre for any elective and emergency procedures

Interventions

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Colorectal Bundle

1. Preoperative optimization of the nutritional status: Perform nutritional risk screening (NRS), measure albumin or prealbumin preoperatively and initiate nutritional support
2. Preoperative showering with an antiseptic agent
3. Administer preoperative antibiotic prophylaxis
4. Hair removal in the operative field with clippers
5. Peri-, intra-, and postoperative warming to maintain body temperature
6. Peri- and intraoperative glucose control
7. Usage of a wound protection device
8. Change of gloves and instruments after anastomosis
9. Anastomosis only with experienced senior surgeon present in theatre for any elective and emergency procedures

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* aged ≥ 18 years
* Patients undergoing any left sided emergency or elective colorectal resections
* Patients should have given or will give a general consent

Exclusion Criteria

* no general consent given
* unable to provide informed general consent
* vulnerable patients (Age \< 18 years or patients with severe dementia)
* the intervention is a reoperation within 30 days of primary operation


* known allergy to one of the applied antibiotic regimes
* active bacterial infection requiring systemic antibiotics
* IV or oral antibiotics in past 7 days prior to the planned decontamination
* terminal kidney disease
* unable to take antibiotic decontamination medication
* pregnancy or breastfeeding
* emergency or expedited surgery
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Centre Biel/Bienne

OTHER

Sponsor Role collaborator

Luzerner Kantonsspital

OTHER

Sponsor Role collaborator

Kantonsspital Aarau

OTHER

Sponsor Role collaborator

Kantonsspital Liestal

OTHER

Sponsor Role collaborator

Spital Limmattal Schlieren

OTHER

Sponsor Role collaborator

Kantonsspital Olten

OTHER

Sponsor Role collaborator

Clarunis - Universitäres Bauchzentrum Basel

OTHER

Sponsor Role collaborator

University Hospital, Basel, Switzerland

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marco von Strauss und Tourney, PD Dr.

Role: PRINCIPAL_INVESTIGATOR

Clarunis - Universitäres Bauchzentrum Basel

Markus Zuber, Prof. Dr.

Role: STUDY_DIRECTOR

Clarunis - Universitäres Bauchzentrum Basel

Locations

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Kantonsspital Baselland

Liestal, Basel-Landschaft, Switzerland

Site Status

Lantonsspital Aarau

Aarau, Canton of Aargau, Switzerland

Site Status

Clarunis-universitäres Bauchzentrum

Basel, Canton of Basel-City, Switzerland

Site Status

Spitalzentrum Biel

Biel/Bienne, Canton of Bern, Switzerland

Site Status

Kantonsspital Luzern

Lucerne, Canton of Lucerne, Switzerland

Site Status

Kantonsspital Olten

Olten, Canton of Solothurn, Switzerland

Site Status

Spital Limmattal

Schlieren, Canton of Zurich, Switzerland

Site Status

Countries

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Switzerland

References

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Wiesler B, Gass JM, Galli R, Worni M, Nebiker C, Muller A, Pabst M, Stimpfle D, Werlen L, von Strauss Und Torney M; Clarunis EvaCol Study Group. Is There Still a Need to Discuss the Use of Antibiotic Decontamination? Results of a Prospective Cohort Study Involving 999 Left-Sided Colorectal Resections. J Am Coll Surg. 2025 Sep 1;241(3):474-483. doi: 10.1097/XCS.0000000000001396. Epub 2025 Aug 14.

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Wiesler B, Gass JM, Viehl CT, Muller A, Metzger J, Hartel M, Nebiker C, Rosenberg R, Galli R, Zingg U, Ochsner A, Eisner L, Pabst M, Worni M, Henschel M, von Flue M, Zuber M, von Strauss Und Torney M. Evaluation of the Introduction of a Colorectal Bundle in Left Sided Colorectal Resections (EvaCol): Study Protocol of a Multicentre, Observational Trial. Int J Surg Protoc. 2022 Jul 14;26(1):57-67. doi: 10.29337/ijsp.177. eCollection 2022.

Reference Type DERIVED
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Other Identifiers

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EvaCol

Identifier Type: -

Identifier Source: org_study_id

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