Health Condition 1: K566- Other and unspecified intestinal obstruction Health Condition 2: K565- Intestinal adhesions [bands] withobstruction (postinfection) Health Condition 3: K561- Intussusception Health Condition 4: K562- Volvulus Health Condition 5: K631- Perforation of intestine (nontraumatic) Health Condition 6: K251- Acute gastric ulcer with perforation Health Condition 7: K255- Chronic or unspecified gastric ulcer with perforation Health Condition 8: K261- Acute duodenal ulcer with perf
Conditions
Interventions
Intervention1: ERAS Protocol: Patients in this group will receive perioperative care according to ERAS guidelines as follows
Pre-operatively:
Brief Counselling and Written Consent
Rapid identificat
Sponsors
Dr Twvisham Srivastava
Eligibility
Inclusion criteria
Inclusion criteria: 1) Adult patients aged 18 years and older 2) Patients planned for emergency laparotomy (high-risk emergency general surgical procedures) 3) Patients in whom a diagnosis has been established before surgery, and laparotomy isn t done for diagnostic purposes 4) Patients who provide informed consent to participate in the study
Exclusion criteria
Exclusion criteria: 1) Patients requiring emergent intervention for complications after having undergone an elective procedure in the last 3 months 2) Patients presenting with acute trauma, as aggressive volume resuscitation is a prerequisite in both the pre- and post-operative period 3) Patients with established vital organ failure (Multiple/ Single Organ Dysfunction) 4) Pregnant females will be excluded due to potential risks to maternal and fetal health and limitations in imaging modalities 5) Patients who underwent administration of immunosuppressive agents in the past month 6) Patients with cognitive impairment or inability to provide informed consent 7) Patients who require post-operative ventilatory support or have any organ dysfunction will be excluded 8) Hollow viscus perforation (gastric/duodenal perforation) patients with perforation size more than 10 mm are excluded, as early nutrition is not feasible in these patients 9) Patients who need re-exploration after index surgery will be excluded
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Early physiological recovery of the patient post operatively leading to shorter hospital stayTimepoint: Primary outcome by design will be assessed at the time of discharge of patient from the facility on post operative days 3, 5 and 7 from day of surgery | — |
Secondary
| Measure | Time frame |
|---|---|
| Ascertaining the incidence of failure of ERAS protocol and correlating the incidence with P-POSSUM risk stratification score.Timepoint: Patients will be followed up on a daily basis in the postoperative period and 1 week and 1 month after discharge;Comparison of the rate of post-operative complications (SSI, post operative ileus, post operative pulmonary compromise) between the two groups and quantify post operative inflammatory stress using blood markers (CRP, Albumin drop, CAR ratio)Timepoint: Patients will be followed up on a daily basis in the postoperative period and 1 week and 1 month after discharge | — |
Countries
India
Contacts
Public ContactDr Ravi Gupta
All India Institute of Medical Sciences Gorakhpur
Outcome results
None listed