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Colorectal SurgeryColon-AmbuNCT03760939

Clinical and Economical Evaluation of Colorectal Surgery in Ambulatory Care

A study testing Clinical and economical evaluation in people with Colorectal Surgery, run by IHU Strasbourg at 1 site in France.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Enhanced recovery after surgery (ERAS) significantly decreases mortality, morbidity and hospital length of stay without increasing the rate of re-hospitalization. It reduces psychologic stress caused by surgery and decreases postoperative complications about 50 %, especially in colorectal surgery. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Colorectal Surgery
What is being tested?
Clinical and economical evaluation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
5 participants
Where
1 siteFrance
Study dates
3 Jan 2019to 15 Nov 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female over 18 years old
  • Patient able to understand the objectives and risks related to the trial
  • Patient able to give written informed consent
  • Patient able to understand and accept the health care program
  • Isolated colonic lesion located on the colon or the upper rectum
  • Any neoplastic or non-neoplastic colonic pathology
Show all 12Show fewer
  • Colonic surgery except resection without continuity interruption (e.g. low cecum resection, partial colectomy, suture for polyp)
  • Moderate and/or controlled comorbidities
  • No history of multiple laparotomies
  • No psychosocial distress
  • No living alone patient
  • Patient registered with the French social security

Who cannot join

  • Patient in exclusion period of another clinical study
  • Emergency surgical procedure
  • Type 1 diabetes
  • Presence of an uncontrolled preoperative anemia
  • Effective anticoagulation treatment, impossible to suspend
  • Kidney failure (treated by dialysis)
Show all 13Show fewer
  • Hepatic cirrhosis
  • Patient refusal
  • Patient in custody
  • Patient under guardianship
  • Pregnancy
  • Breastfeeding
  • Poor general condition

Trial locations and contacts

1 site in 1 country.

France1 site
  • Service de Chirurgie Digestive et Endocrinienne - Nouvel Hôpital Civil

    Strasbourg, 67091

Other trials in France

About this study

Enhanced recovery after surgery (ERAS) significantly decreases mortality, morbidity and hospital length of stay without increasing the rate of re-hospitalization. It reduces psychologic stress caused by surgery and decreases postoperative complications about 50 %, especially in colorectal surgery. ERAS is now the object of several Good Practices Recommendations and is about to become the reference strategy.

The development of ambulatory surgery is a French national concern. Its interest has been demonstrated in many surgical fields. It requires a reflection centered on the patient and a health care pathway organization involving all health care actors.

Read more

While hospitalization is still the standard practice for colonic surgery, the objective of this study is to evaluate the medical and economic impact of an ambulatory care for colorectal surgery.

Ambulatory care will be compared to standard hospitalization of patients who benefit from the ERAS program.

Read the detailed description

Enhanced recovery after surgery (ERAS) significantly decreases mortality, morbidity and hospital length of stay without increasing the rate of re-hospitalization. It reduces psychologic stress caused by surgery and decreases postoperative complications about 50 %, especially in colorectal surgery. ERAS is now the object of several Good Practices Recommendations and is about to become the reference strategy.

The development of ambulatory surgery is a French national concern. Its interest has been demonstrated in many surgical fields. It requires a reflection centered on the patient and a health care pathway organization involving all health care actors. Multiple interests have been shown:

  • Equivalent mortality and/or morbidity compared with standard hospitalizations
  • Medical and psychological benefits
  • Individualized and less invasive health care pathways, in favor of patient's autonomy
  • Multidisciplinary approach and innovative care
  • Heath care costs management (decrease of hospital length of stay, optimization of operating rooms).

Ambulatory colectomies feasibility is recognized since 2013-2014 in France (Dr. Gignoux, MD in Lyon and Dr. Chasserant, MD in Le Havre). These ambulatory procedures are implemented in few expert centers with significant experience (more than 100 patients in Le Havre and more than 85 patients in Lyon) but several human and organizational limitations slow this innovative care.

The risk of complications does not seem to be increased on condition of anticipate and provide a postoperative follow-up at home.

While hospitalization is still the standard practice for colonic surgery, the objective of this study is to evaluate the medical and economic impact of an ambulatory care for colorectal surgery.

Ambulatory care will be compared to standard hospitalization of patients who benefit from the ERAS program.

Being tested
Clinical and economical evaluation
Keywords
Colorectal surgery, Ambulatory care, Medical and economic evaluation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Clinical and economical evaluationOther

    Evaluation of the clinical and the economical impact of a colorectal surgery

Study groups in NCT03760939
Study groupRoleWhat they receive
Ambulatory careExperimentalColorectal surgery in ambulatory care
Receives: Other: Clinical and economical evaluation
Standard hospitalizationOtherColorectal surgery with standard hospitalization for retrospective patients who benefit from the ERAS program, selected by statistical matching.
Receives: Other: Clinical and economical evaluation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean cost evaluation

    Mean cost evaluation, for the hospital, of the ambulatory care compared with standard hospitalization for patients who benefit from the ERAS program.

    Measured: 1 month

Secondary outcomes (15)
  1. Quality of life evaluation: EQ-5D (EuroQoL-5 Dimensions) scale

    The EQ-5D Quality of Life scale consists of :

    (i) a descriptive system, consists in 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems, extreme problems.

    (ii) a visual analog scale, records the respondent's self-rated health on a vertical, visual analogue scale where the endpoints are labelled 'Best imaginable health state" and "Worst imaginable health state".

    Measured: 7 and 30 days

  2. Mean hospital length of stay

    Mean hospital length of stay for the "standard hospitalization" group

    Measured: 2 years and 3 months

  3. Ambulatory colectomies rate

    Rate of ambulatory colectomies compared to the total number of colectomies performed

    Measured: 2 years and 3 months

  4. Ambulatory care failure rate

    Rate of patients scheduled for ambulatory care and non-discharged the evening of surgery

    Measured: 2 years and 3 months

  5. Duty desk call

    Number of patients who called the duty desk (or for whom the duty desk has been called)

    Measured: 2 years and 3 months

  6. Mean time period required for a postoperative complication care

    Mean time period required for a postoperative complication care

    Measured: 2 years and 3 months

  7. Hospital re-admissions rate

    Rate of hospital re-admissions related to postoperative complications

    Measured: 30 days

  8. Rate of complications (Morbidity)

    Rate of complications related or not to surgery

    Measured: 30 days

  9. Rate of death (Mortality)

    Number of patients who died within the individual participation period

    Measured: 30 days

  10. Complications rate

    Clinical and economic evaluation of postoperative complications rates difference between "ambulatory care" group and "standard hospitalization" group

    Measured: 30 days

  11. Complications severity classification

    Clinical and economic evaluation of complications severity assessed by the Clavien-Dindo classification

    Measured: 30 days

  12. Evaluation of complication severity according to Clavien classification

    Severity of the complications will be evaluated according to the Clavien classification from Grade I "Any deviation from the normal postoperative course without the need for pharmacological treatment or surgical, endoscopic and radiological interventions" to Grade V "Death of a patient"

    Measured: 2 years and 3 months

  13. Mean additional hospital length of stay

    Clinical and economic evaluation of hospital length of stay related to complications difference between "ambulatory care" group and "standard hospitalization" group (additional hospitalizations, extension of hospitalization or new hospitalization).

    Measured: 2 years and 3 months

  14. Costs related to postoperative complications

    Costs related to postoperative complications difference between "ambulatory care" group and "standard hospitalization" group

    Measured: 2 years and 3 months

  15. Costs related to the management of postoperative complications

    Overall costs are evaluated by individual costs of:

    • unscheduled consultations,
    • surgical treatment,
    • medicated treatment
    • hospitalisation's duration

    Measured: 2 years and 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Dec 2018
  2. Study start3 Jan 2019
  3. Primary completion15 Nov 2024
  4. Study completion15 Nov 2024

Why it stopped: Inclusion difficulties

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
5 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03760939
Sponsor's protocol ID
18-001
Acronym
Colon-Ambu
Status last verified
Apr 2025
First submitted
29 Nov 2018
Last updated
1 May 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Gignoux B, Pasquer A, Vulliez A, Lanz T. Outpatient colectomy within an enhanced recovery program. J Visc Surg. 2015 Feb;152(1):11-5. doi: 10.1016/j.jviscsurg.2014.12.004. Epub 2015 Feb 7.

    PubMed 25661787
  • Chasserant P, Gosgnach M. Improvement of peri-operative patient management to enable outpatient colectomy. J Visc Surg. 2016 Nov;153(5):333-337. doi: 10.1016/j.jviscsurg.2016.07.006. Epub 2016 Sep 23.

    PubMed 27671006
  • Slim K; Groupe GRACE (Groupe francophone de rehabilitation amelioree apres chirurgie); Amalberti R. Ambulatory colectomy: no innovation without evaluation. J Visc Surg. 2015 Feb;152(1):1-3. doi: 10.1016/j.jviscsurg.2015.01.001. Epub 2015 Jan 31. No abstract available.

    PubMed 25650365
  • Wind J, Polle SW, Fung Kon Jin PH, Dejong CH, von Meyenfeldt MF, Ubbink DT, Gouma DJ, Bemelman WA; Laparoscopy and/or Fast Track Multimodal Management Versus Standard Care (LAFA) Study Group; Enhanced Recovery after Surgery (ERAS) Group. Systematic review of enhanced recovery programmes in colonic surgery. Br J Surg. 2006 Jul;93(7):800-9. doi: 10.1002/bjs.5384.

    PubMed 16775831
  • Walter CJ, Collin J, Dumville JC, Drew PJ, Monson JR. Enhanced recovery in colorectal resections: a systematic review and meta-analysis. Colorectal Dis. 2009 May;11(4):344-53. doi: 10.1111/j.1463-1318.2009.01789.x. Epub 2009 Feb 4.

    PubMed 19207699
  • Gouvas N, Tan E, Windsor A, Xynos E, Tekkis PP. Fast-track vs standard care in colorectal surgery: a meta-analysis update. Int J Colorectal Dis. 2009 Oct;24(10):1119-31. doi: 10.1007/s00384-009-0703-5. Epub 2009 May 5.

    PubMed 19415308
  • Varadhan KK, Neal KR, Dejong CH, Fearon KC, Ljungqvist O, Lobo DN. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr. 2010 Aug;29(4):434-40. doi: 10.1016/j.clnu.2010.01.004. Epub 2010 Jan 29.

    PubMed 20116145
  • Adamina M, Kehlet H, Tomlinson GA, Senagore AJ, Delaney CP. Enhanced recovery pathways optimize health outcomes and resource utilization: a meta-analysis of randomized controlled trials in colorectal surgery. Surgery. 2011 Jun;149(6):830-40. doi: 10.1016/j.surg.2010.11.003. Epub 2011 Jan 14.

    PubMed 21236454
  • Spanjersberg WR, Reurings J, Keus F, van Laarhoven CJ. Fast track surgery versus conventional recovery strategies for colorectal surgery. Cochrane Database Syst Rev. 2011 Feb 16;2011(2):CD007635. doi: 10.1002/14651858.CD007635.pub2.

    PubMed 21328298
  • Slim K, Delaunay L, Joris J, Leonard D, Raspado O, Chambrier C, Ostermann S; Le Groupe francophone de rehabilitation amelioree apres chirurgie (GRACE). How to implement an enhanced recovery program? Proposals from the Francophone Group for enhanced recovery after surgery (GRACE). J Visc Surg. 2016 Dec;153(6S):S45-S49. doi: 10.1016/j.jviscsurg.2016.05.008. Epub 2016 Jun 14. No abstract available.

    PubMed 27316295
  • Gustafsson UO, Oppelstrup H, Thorell A, Nygren J, Ljungqvist O. Adherence to the ERAS protocol is Associated with 5-Year Survival After Colorectal Cancer Surgery: A Retrospective Cohort Study. World J Surg. 2016 Jul;40(7):1741-7. doi: 10.1007/s00268-016-3460-y.

    PubMed 26913728
  • Lawrence JK, Keller DS, Samia H, Ermlich B, Brady KM, Nobel T, Stein SL, Delaney CP. Discharge within 24 to 72 hours of colorectal surgery is associated with low readmission rates when using Enhanced Recovery Pathways. J Am Coll Surg. 2013 Mar;216(3):390-4. doi: 10.1016/j.jamcollsurg.2012.12.014. Epub 2013 Jan 23.

    PubMed 23352608
  • Bardram L, Funch-Jensen P, Jensen P, Crawford ME, Kehlet H. Recovery after laparoscopic colonic surgery with epidural analgesia, and early oral nutrition and mobilisation. Lancet. 1995 Mar 25;345(8952):763-4. doi: 10.1016/s0140-6736(95)90643-6.

    PubMed 7891489
  • Levy BF, Scott MJ, Fawcett WJ, Rockall TA. 23-hour-stay laparoscopic colectomy. Dis Colon Rectum. 2009 Jul;52(7):1239-43. doi: 10.1007/DCR.0b013e3181a0b32d.

    PubMed 19571699
  • Gash KJ, Goede AC, Chambers W, Greenslade GL, Dixon AR. Laparoendoscopic single-site surgery is feasible in complex colorectal resections and could enable day case colectomy. Surg Endosc. 2011 Mar;25(3):835-40. doi: 10.1007/s00464-010-1275-8. Epub 2010 Aug 24.

    PubMed 20734083

Questions about this trial

What is this clinical trial studying?

A study testing Clinical and economical evaluation in people with Colorectal Surgery, run by IHU Strasbourg at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 1 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Inclusion difficulties). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean cost evaluation (time frame: 1 month). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03760939, which also lists 21 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 May 2025.

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