Early Post-Op Recovery After Partial Large Bowel Resection
Condition: Diverticulitis; Colon Polyps; Colorectal Cancer
MeSH terms: Diverticulitis
Study type: Observational

Summary: 
      The purpose of this trial is to gather information on the postoperative recovery time and
      hospital length of stay experienced by patients having laparoscopic surgeries. This trial
      will also collect data on daily surgical pain and pain medication and how it relates to
      recovery after surgery. In addition, the investigators will collect data on the use of pain
      medication and laxatives in patients following laparoscopic large bowel resection.
    

Detailed description: 
      Laparoscopic surgery was initially performed by surgeons in France in 1987 and was introduced
      in the United States in 1988. This minimally invasive procedure was performed for
      cholecystectomy, and is now the standard of care in the treatment of gallbladder disease.
      Recent advances in laparoscopic surgery and its success in cholecystectomy have permitted the
      procedure to be used for treating a variety of diseases and for diagnosing and staging.

      Minimally invasive laparoscopic surgery has advantages over conventional open surgery,
      including smaller incisions, earlier gastrointestinal (GI) recovery, shorter hospital stays,
      less pain, and fewer complications. In recent years evidence is accumulating for some
      operations that laparoscopic procedures produce outcomes that are comparable to those
      produced by routine open surgery and may actually surpass others.

      Whereas laparoscopic surgery has been successful and well accepted for various abdominal and
      pelvic surgeries, its use in the area of colorectal surgery has progressed at a slower rate.
      There are challenges impacting the wider use of laparoscopic bowel resection (LBR). These
      include the technical difficulty associated with the size of the colon, the need for complete
      immobilization of the bowel and the need for a watertight, non-leaking anastomosis. In
      addition, the equipment is expensive and surgeons require specialized training.

      Results from studies in colon cancer now indicate that LBR reduces perioperative morbidity,
      and decreases hospital stay with comparable cancer-related survival as compared to open
      colectomy. The use of LBR in short-term outcomes is increasing because clinical trial data
      have demonstrated superiority of LBR, particularly in short-term outcomes over conventional
      open surgery.

      Gastrointestinal recovery and related patient outcomes during the early postoperative period
      following open segmental colon resection have been extensively evaluated in previous
      randomized, controlled, multicenter trials. Current data in laparoscopic colectomy have been
      collected from retrospective, single center clinical trials which lacked standardized
      definitions and endpoints. Therefore, this prospective, multicenter study in LBR is being
      undertaken to determine how this surgical technique impacts GI recovery and related outcomes
      relative to the open laparotomy.

      The primary objective of this study is to assess the clinical course of gastrointestinal (GI)
      recovery and hospital length of stay in subjects undergoing laparoscopic partial large bowel
      resection. The secondary objective is to assess the immediate post discharge clinical course
      of subjects undergoing laparoscopic bowel resection with respect to opioid-induced GI
      effects, daily surgical pain, opioid consumption and laxative use.
    

Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Colorectal Surgery clinic population
      
Keywords: Hand assist laparoscopic partial large bowel resection; Laparoscopic partial large bowel resection