AzTrials
AzTrials

Ileostomy - StomaILEONCT03941522

Loop Ileostomy Closure as a 23-hour Stay Procedure, a Multi-center Randomized Controlled Trial

A study testing Early discharge from hospital in people with Ileostomy - Stoma, run by CHU de Quebec-Universite Laval at 2 sites in Canada.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

The purpose of this study is to assess the safety and feasibility of ileostomy closure performed in a 23 hours hospitalization setting, using a multi-center, open-label, randomized controlled trial comparing patients being hospitalized overnight (discharged on the day after surgery) to patients being hospitalized as… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Ileostomy - Stoma
What is being tested?
Early discharge from hospital
Could I receive a placebo?
No, everyone receives an active treatment
How many people
168 participants
Where
2 sitesCanada
Study dates
Jun 2019to Jun 2021
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
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Aged 18 years and older
  • Able to provide informed consent
  • ASA I and II (American Society of Anesthesiologists)
  • Staying less than 50 kilometers from a hospital after surgery
  • Being accompanied by an adult able to assist the patient in his recovery and to intervene in case of an emergency for the first 48 hours after surgery
  • No anastomotic leak proven on preoperative water soluble enema

Who cannot join

  • Language barrier or significant communication problem
  • Immunosuppression
  • Therapeutic anticoagulation
  • Previous proctocolectomy
  • Previous ileal pouch anal anastomosis
  • Technical factors during surgery (conversion to midline laparotomy or other, at surgeon's discretion)

Trial locations and contacts

2 sites in 1 country.

Xavier Paré, MD contact

418-684-7482

xavier.pare.2@ulaval.ca

Geneviève Morin, MD contact

418-641-9284

genevieve.morin.27@ulaval.ca

Canada2 sites
  • Hôpital Saint-François d'Assise

    Québec, Quebec, G1L 3L5

    Xavier Paré, MD, 418-684-7482, xavier.pare.2@ulaval.ca

    Geneviève Morin, MD, 418-641-9284, genevieve.morin.27@ulaval.ca

  • Hôtel-Dieu de Québec

    Québec, G1R 2J6

    Xavier Paré, MD, 418-684-7482, xavier.pare.2@ulaval.ca

    Geneviève Morin, MD, 418-641-9284, genevieve.morin.27@ulaval.ca

Other trials in Canada

About this study

The purpose of this study is to assess the safety and feasibility of ileostomy closure performed in a 23 hours hospitalization setting, using a multi-center, open-label, randomized controlled trial comparing patients being hospitalized overnight (discharged on the day after surgery) to patients being hospitalized as per the current conventional care after ileostomy closure with both groups following a standardized enhanced recovery after surgery (ERAS) pathway specific to ileostomy closure. Primary outcome will be total length of hospital stay in days and secondary outcomes, measured at 30 days, will include readmission rate, postoperative complication rate minor and severe, postoperative ileus rate, postoperative surgical site infection rate and mortality rate.

Read the detailed description

Rationale :

Loop ileostomy is defined by bringing a loop of small bowel out onto the surface of the skin to allow diversion of the fecal stream. It is a common procedure that is conjointly done with colorectal surgeries with the objective to protect intestinal anastomosis at high risk of leaking. Loop ileostomy closure is then performed in the months following the initial surgery when the anastomosis has healed. Often thought of as a simple procedure, it is still associated with a significant postoperative morbidity rate consisting mostly of postoperative ileus. In the CHU de Québec-Université Laval, patients are hospitalized for a median of five days until their bowels open up while no active care is given. This represents 645 days of hospitalization each year for Hôpital Saint-François d'Assise (HSFA), Hôtel-Dieu de Québec (HDQ) and Centre Hospitalier de l'Université Laval (CHUL). Hence, there is a clear need to determine if the investigator can improve the outcomes following ileostomy closure by applying a standardized enhanced recovery pathway specific to ileostomy closure to the point where the surgery can be performed in a twenty-three hours hospitalization setting.

Objective :

The purpose of this study is to assess the safety and feasibility of ileostomy closure performed in a 23 hours hospitalization setting, using a multi-center, open-label, randomized controlled trial comparing patients being hospitalized overnight (discharged on the day after surgery) to patients being hospitalized as per the current conventional care after ileostomy closure with both groups following a standardized enhanced recovery after surgery (ERAS) pathway specific to ileostomy closure. Primary outcome will be total length of hospital stay in days and secondary outcomes, measured at 30 days, will include readmission rate, postoperative complication rate minor and severe, postoperative ileus rate, postoperative surgical site infection rate and mortality rate.

Hypothesis :

The investigator believes patients randomized to the group 23-hour stay will have reduced total length of hospital stay compared to patients randomized to the group conventional hospitalization after ileostomy closure.

Methods :

Healthy adults (ASA I and II) undergoing elective ileostomy closure who consented to take part in the study will be enrolled in a standardized enhanced recovery pathway specific to ileostomy closure. Once surgery is completed, they will be randomized to either 23-hour stay or conventional hospitalization. Data on postoperative outcomes will be gathered prospectively until 30 days after surgery and will include total length of hospital stay in days, readmissions, postoperative complications, more precisely postoperative ileus and surgical site infections, as well as mortality.

Clinical significance :

If safety and feasibility of a fast discharge of patients is demonstrated by this study, it would then mean that patients could be discharged from hospital less than 24 hours after a loop ileostomy closure. It could potentially lower the consequences of a long hospital stay for patients, such as risks of nosocomial infections, thromboembolic events, and hospital acquired autonomy loss.

Being tested
Early discharge from hospital
Keywords
loop ileostomy, diversion ileostomy, ileostomy closure

What participants receive

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

  • Early discharge from hospitalOther

    Patients randomized to the group 23-hour stay will be discharged on the day after their surgery if they meet the discharge criteria.

Study groups in NCT03941522
Study groupRoleWhat they receive
Intervention group (23-hour stay)ExperimentalPatients randomized to the group 23-hour stay will be discharged on the day after their surgery if they meet the discharge criteria.
Receives: Other: Early discharge from hospital
Control group (conventional hospitalization)No interventionPatients randomized to the group conventional hospitalization will be hospitalized as per the current conventional care after ileostomy closure.

What is being measured

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

  1. Total length of hospital stay

    The number of days spent in the hospital from the time of the surgery to the time of the discharge as well as any day spent in the hospital after any readmission in the 30 days following the ileostomy closure.

    Measured: 30 days after surgery

Secondary outcomes (5)
  1. Readmission rate

    Any hospitalisation after surgery

    Measured: 30 days after surgery

  2. Postoperative complication rate

    Any complication after surgery

    Measured: 30 days after surgery

  3. Postoperative ileus rate

    Ileus necessitating installation of a nasogastric tube

    Measured: 30 days after surgery

  4. Postoperative surgical site infection rate

    Infection of the surgical site

    Measured: 30 days after surgery

  5. Postoperative mortality rate

    Death after the surgery

    Measured: 30 days after surgery

Timeline

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

  1. First posted8 May 2019
  2. Study startJun 2019 (estimated)
  3. Primary completionApr 2021 (estimated)
  4. Study completionJun 2021 (estimated)

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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
168 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03941522
Sponsor's protocol ID
2019-4382
Acronym
ILEO
Status last verified
Jun 2019
First submitted
6 May 2019
Last updated
12 Jun 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Huser N, Michalski CW, Erkan M, Schuster T, Rosenberg R, Kleeff J, Friess H. Systematic review and meta-analysis of the role of defunctioning stoma in low rectal cancer surgery. Ann Surg. 2008 Jul;248(1):52-60. doi: 10.1097/SLA.0b013e318176bf65.

    PubMed 18580207
  • Tan WS, Tang CL, Shi L, Eu KW. Meta-analysis of defunctioning stomas in low anterior resection for rectal cancer. Br J Surg. 2009 May;96(5):462-72. doi: 10.1002/bjs.6594.

    PubMed 19358171
  • Chen J, Wang DR, Yu HF, Zhao ZK, Wang LH, Li YK. Defunctioning stoma in low anterior resection for rectal cancer: a meta- analysis of five recent studies. Hepatogastroenterology. 2012 Sep;59(118):1828-31. doi: 10.5754/hge11786.

    PubMed 22193436
  • Koperna T. Cost-effectiveness of defunctioning stomas in low anterior resections for rectal cancer: a call for benchmarking. Arch Surg. 2003 Dec;138(12):1334-8; discussion 1339. doi: 10.1001/archsurg.138.12.1334.

    PubMed 14662534
  • Wong KS, Remzi FH, Gorgun E, Arrigain S, Church JM, Preen M, Fazio VW. Loop ileostomy closure after restorative proctocolectomy: outcome in 1,504 patients. Dis Colon Rectum. 2005 Feb;48(2):243-50. doi: 10.1007/s10350-004-0771-0.

    PubMed 15714246
  • D'Haeninck A, Wolthuis AM, Penninckx F, D'Hondt M, D'Hoore A. Morbidity after closure of a defunctioning loop ileostomy. Acta Chir Belg. 2011 May-Jun;111(3):136-41. doi: 10.1080/00015458.2011.11680724.

    PubMed 21780519
  • Giannakopoulos GF, Veenhof AA, van der Peet DL, Sietses C, Meijerink WJ, Cuesta MA. Morbidity and complications of protective loop ileostomy. Colorectal Dis. 2009 Jul;11(6):609-12. doi: 10.1111/j.1463-1318.2008.01690.x. Epub 2008 Oct 1.

    PubMed 19175642
  • Chow A, Tilney HS, Paraskeva P, Jeyarajah S, Zacharakis E, Purkayastha S. The morbidity surrounding reversal of defunctioning ileostomies: a systematic review of 48 studies including 6,107 cases. Int J Colorectal Dis. 2009 Jun;24(6):711-23. doi: 10.1007/s00384-009-0660-z. Epub 2009 Feb 17.

    PubMed 19221766
  • Loffler T, Rossion I, Bruckner T, Diener MK, Koch M, von Frankenberg M, Pochhammer J, Thomusch O, Kijak T, Simon T, Mihaljevic AL, Kruger M, Stein E, Prechtl G, Hodina R, Michal W, Strunk R, Henkel K, Bunse J, Jaschke G, Politt D, Heistermann HP, Fusser M, Lange C, Stamm A, Vosschulte A, Holzer R, Partecke LI, Burdzik E, Hug HM, Luntz SP, Kieser M, Buchler MW, Weitz J; HASTA Trial Group. HAnd Suture Versus STApling for Closure of Loop Ileostomy (HASTA Trial): results of a multicenter randomized trial (DRKS00000040). Ann Surg. 2012 Nov;256(5):828-35; discussion 835-6. doi: 10.1097/SLA.0b013e318272df97.

    PubMed 23095628
  • Luglio G, Pendlimari R, Holubar SD, Cima RR, Nelson H. Loop ileostomy reversal after colon and rectal surgery: a single institutional 5-year experience in 944 patients. Arch Surg. 2011 Oct;146(10):1191-6. doi: 10.1001/archsurg.2011.234.

    PubMed 22006879
  • Hiranyakas A, Rather A, da Silva G, Weiss EG, Wexner SD. Loop ileostomy closure after laparoscopic versus open surgery: is there a difference? Surg Endosc. 2013 Jan;27(1):90-4. doi: 10.1007/s00464-012-2422-1. Epub 2012 Jun 30.

    PubMed 22752281
  • Mengual-Ballester M, Garcia-Marin JA, Pellicer-Franco E, Guillen-Paredes MP, Garcia-Garcia ML, Cases-Baldo MJ, Aguayo-Albasini JL. Protective ileostomy: complications and mortality associated with its closure. Rev Esp Enferm Dig. 2012 Jul;104(7):350-4. doi: 10.4321/s1130-01082012000700003.

    PubMed 22849495
  • Gong J, Guo Z, Li Y, Gu L, Zhu W, Li J, Li N. Stapled vs hand suture closure of loop ileostomy: a meta-analysis. Colorectal Dis. 2013;15(10):e561-8. doi: 10.1111/codi.12388.

    PubMed 24033921
  • Peacock O, Bhalla A, Simpson JA, Gold S, Hurst NG, Speake WJ, Tierney GM, Lund JN. Twenty-three-hour stay loop ileostomy closures: a pilot study. Tech Coloproctol. 2013 Feb;17(1):45-9. doi: 10.1007/s10151-012-0880-z. Epub 2012 Aug 31.

    PubMed 22936588
  • Peacock O, Law CI, Collins PW, Speake WJ, Lund JN, Tierney GM. Closure of loop ileostomy: potentially a daycase procedure? Tech Coloproctol. 2011 Dec;15(4):431-7. doi: 10.1007/s10151-011-0781-6. Epub 2011 Oct 28.

    PubMed 22033543

Questions about this trial

What is this clinical trial studying?

A study testing Early discharge from hospital in people with Ileostomy - Stoma, run by CHU de Quebec-Universite Laval at 2 sites in Canada.

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 6 inclusion and 6 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: status not confirmed, as of the sponsor's last update on 12 Jun 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Canada. 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?

Results are not available in the source record.

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

Contact Xavier Paré, MD (418-684-7482, xavier.pare.2@ulaval.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Total length of hospital stay (time frame: 30 days after surgery). 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 NCT03941522, which also lists 34 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 12 Jun 2019.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in