Evidence map›Paper›PMID 28806303›Full record

Trial reportAnnals of surgery2017

Does a Combination of Laparoscopic Approach and Full Fast Track Multimodal Management Decrease Postoperative Morbidity?: A Multicenter Randomized Controlled Trial.

Léon Maggiori, Eric Rullier, Jérémie H Lefevre, Jean-Marc Régimbeau, Stéphane Berdah, Mehdi Karoui, Jérome Loriau, Arnaud Alvès, Eric Vicaut, Yves Panis

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Annals of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
2.8field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.

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  11. A Standardized Multimodal Analgesia Protocol Reduces Perioperative Opioid Use in Minimally Invasive Colorectal Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 1 country.

Léon Maggiori*Colorectal Surgery Department, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, University Paris VII, Clichy, France †Colorectal unit, Hôpital Haut Lévêque, CHU Bordeaux, University of Bordeaux, Bordeaux, France ‡Digestive Surgery Department, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Pierre & Marie Curie University (Paris VI), Paris, France §Department of Digestive and Oncological Surgery, Amiens-Picardie University Medical Center, Amiens, France ¶Department of Digestive Surgery, Hôpital Nord, Aix-Marseille University, Marseille, France ||Department of Digestive and Hepato-Pancreato-Biliary Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Pierre & Marie Curie University (Paris VI), Paris, France **Department of Digestive Surgery, Hôpital Saint-Joseph, Paris, France ††Department of Digestive Surgery, University Hospital of Caen, University of Caen Normandy, Caen, France ‡‡Department of Clinical Research, Hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, University Paris VII, Paris, France.
Eric Rullier
Jérémie H Lefevre
Jean-Marc Régimbeau
Stéphane Berdah
Mehdi Karoui
Jérome Loriau
Arnaud Alvès
Eric Vicaut
Yves Panis
Université de Bordeaux · FRAssistance Publique – Hôpitaux de Paris · FRCentre Hospitalier Universitaire Amiens-Picardie · FRHôpital Beaujon · FRHôpital Nord · FRSorbonne Université · FRUniversité Paris Cité · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study was to assess whether association of laparoscopic approach and full fast track multimodal (FFT) management can reduce postoperative morbidity after colorectal cancer surgery, as compared to laparoscopic approach with limited fast-track program (LFT). SUMMARY OF BACKGROUND DATA: Recent advances in colorectal cancer surgery are introduction of laparoscopy and FFT implementation.

methodsPatients eligible for elective laparoscopic colorectal cancer surgery were randomized into 2 groups: FFT or LFT care (with only early oral intake and mobilization starting on Day 1). Primary outcome was postoperative 30-day morbidity, according to Clavien-Dindo classification.

resultsTwo hundred seventy patients were randomized and 263 were analyzed: 130 in FFT group and 133 in LFT group, including 106 colon (FFT: n = 52 and LFT: n = 54) and 157 rectal cancer (FFT: n = 78 and LFT: n = 79). Postoperative 30-day mortality was nil. Overall postoperative 30-day morbidity did not show any difference between the groups (FFT: 35% vs LFT: 29%, P = 0.290), neither regarding the overall population, nor in the colon (FFT: 23% vs LFT: 19%, P = 0.636) or rectal (FFT: 44% vs LFT: 35%, P = 0.330) cancer subgroups. Severe postoperative morbidity was also not different between groups (FFT: 12% vs LFT: 8%, P = 0.266). After multivariate regression analysis, only early intravenous catheter removal (on day 2) [odds ratio: 0.390; 95% confidence interval: (95% CI 0.181-0.842); P = 0.017] and the absence of intraoperative lidocaine intravenous perfusion (odds ratio: 0.182, 95% CI 0.042-0.788; P = 0.019) were identified as independent predictive factors of reduced postoperative morbidity.

conclusionAddition of FFT multimodal management to laparoscopic approach with early oral intake and mobilization does not reduce postoperative morbidity after colorectal cancer surgery.

Indexed as

Elective Surgical ProceduresLaparoscopyAdolescentAdultAgedAged, 80 and overColectomyColorectal NeoplasmsFemaleFollow-Up StudiesHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisPerioperative Care

Identifiers

PMID28806303
OpenAlexW2744630511

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.