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| Name | Class |
|---|---|
| Medtronic | INDUSTRY |
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The success of the enhanced recovery program after surgery leads us to consider outpatient management of the colectomy. To this end, the investigators have designed an observational and prospective study of left laparoscopic colectomy on an outpatient basis. The objective is to assess the harmlessness of this management compared to standard management in the context of a public hospital.
In France, colectomy represents about 40,000 interventions per year, most of them scheduled, and 2/3 in a context of neoplasia. This surgery is associated with numerous postoperative complications. Since the start of Enhanced Recovery After Surgery (ERAS) in 1997, complications have been steadily reduced by optimizing surgical and anaesthetic techniques. At the same time, the average length of post-operative stay has decreased. In 2014, ERAS was the subject of recommendations by the French Society of Anaesthesia and Resuscitation, taken up by the French Health Authority (HAS) in 2016, and which are now an integral part of surgical management in colorectal surgery. More recently, two teams have set up an outpatient colectomy program. The three studies published on this subject show encouraging results, in a private structure, with no increase in postoperative complications.
In accordance with the recommendations on ERAS published by the HAS, a program involving pre-, per- and post-interventional investment, has been put in place. Patients are discharged on D0, followed by close monitoring by a home care nurse twice daily. This nurse is in charge of collecting clinical data in order to detect possible early signs of post-operative complications that would justify re-hospitalisation after a medical-surgical decision.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| outpatient left laparoscopic colectomy | Left laparoscopic laparoscopic colectomy patient managed on an outpatient basis |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Colectomy | Procedure | colectomy due to neoplastic (stage 1) or diverticulosis |
|
| Measure | Description | Time Frame |
|---|---|---|
| 30-day readmission rate | Number of re-hospitalisation after a medical-surgical decision due to post-operative complications | 30 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Pain measurement: pain rating scale | Score at the numerical pain rating scale | 7 days after surgery |
| Mobilization | Time (in hours) between extubation and first mobilization |
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Inclusion Criteria:
Exclusion Criteria:
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Patients taken care for a left colectomy due to colonic neoplasm or diverticulosis
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| Name | Affiliation | Role |
|---|---|---|
| Alexandre Smirnoff, MD | Groupe Hospitalier de la Rochelle Ré Aunis | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Groupe Hospitalier de la Rochelle Ré Aunis | La Rochelle | France |
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| ID | Term |
|---|---|
| D003110 | Colonic Neoplasms |
| D043963 | Diverticulosis, Colonic |
| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
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| ID | Term |
|---|---|
| D003082 | Colectomy |
| ID | Term |
|---|---|
| D000099090 | Surgical Procedures, Colorectal |
| D013505 | Digestive System Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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| Day 0 |
| Ileus | Number of day between surgery and first gas / stool | up to 7 days after surgery |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |