Effectiveness of ERAS on Postoperative Recovery After Minimally Invasive Gastrectomy

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age19+
SponsorSeoul National University Hospital

About this trial

This prospective, randomized, open-label, multicenter study is designed to evaluate the impact of an enhanced recovery after surgery (ERAS) protocol on the rate of meeting discharge criteria in patients undergoing minimally-invasive gastrectomy for gastric cancer. We hypothesize that implementation of our ERAS protocol will significantly increase the proportion of patients who meet standardized discharge criteria following minimally-invasive gastrectomy.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adults aged ≥19 years scheduled to undergo elective laparoscopic or robotic gastrectomy for gastric cancer

American Society of Anesthesiologists physical status classification I to III

Ability to provide written informed consent, demonstrate understanding of the study protocol, and complete patient-reported outcome measures appropriately

Disqualifiers

Requirement for resection of organs other than the stomach during surgery (except for cholecystectomy)

History of upper abdominal surgery (except for cholecystectomy)

Known hypersensitivity to fentanyl, ropivacaine, acetaminophen, or non-steroidal anti-inflammatory drugs

Determined by the investigator or study personnel to be otherwise unsuitable for participation in the study

Trial design

Design model

Parallel

Treatments tested in this trial

  • ERAS protocol

    Procedure/Surgery

    The ERAS protocol includes pre-admission patient education through audiovisual materials; reduction of perioperative fasting duration with preoperative carbohydrate loading and early postoperative oral intake; multimodal prophylaxis for postoperative nausea and vomiting; early removal of surgical drains and intravenous lines; early mobilization; and multimodal analgesia aimed at minimizing postoperative opioid use. The detailed protocol used in this study has been published previously \[https://doi.org/10.5230/jgc.2025.25.e27\].

Treatment groups

308 Participants
are divided into 2 treatment groups
Group A: ERAS groupExperimental treatment 1 intervention
Group B: Conventional groupNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

Proportion of patients who fulfilled all of the predefined discharge criteria

Discharge criteria were defined as meeting all of the following conditions: * Tolerance of a soft blended diet (SBD) for at least 24 hours * Unaided ambulation of at least 600 meters * Adequate pain control, defined as a numeric rating scale (NRS) score of ≤ 3, achieved with oral non-opioid analgesics * Absence of abnormal physical examination findings or laboratory test results

Time frame
At 9:00 AM on postoperative day

Secondary outcomes

1

Postoperative pain score

11-pointed NRS pain score at resting/coughing NRS (0-10): 0,"no pain"; 10, "worst pain imaginable"

Time frame
postoperative 2, 24, 48, and 72 hours
2

Postoperative gastrointestinal dysfunction

I-FEED score 3 points or more (postoperative gastrointestinal intolerance and dysfunction)

Time frame
postoperative 24, 48, and 72 hours
3

Postoperative nausea and vomiting

Incidence of postoperative nausea and vomiting (%)

Time frame
From the end of surgery to 24, 48, and 72 hours postoperatively
4

Quality of recovery assessed using the EQ-5D-5L questionnaire

EQ-5D-5L index scores are calculated from the EQ-5D-5L questionnaire using the Korean value set validated for the Korean population. (range: 0 to 1.000, with higher scores indicating better recovery) (Kim SH, Ahn J, Ock M, et al. The EQ-5D-5L valuation study in Korea. Qual Life Res. 2016; 25: 1845-1852)

Time frame
postoperative 24, 48, and 72 hours

Other outcomes

Sponsors and contacts

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Seoul National University Hospital

Lead sponsor

Seoul National University Bundang Hospital

Collaborator

Seoul National University Boramae Hospital

Collaborator

Severance Hospital

Collaborator

Chungnam National University Hospital

Collaborator

Keimyung University Dongsan Medical Center

Collaborator

National Cancer Center, Korea

Collaborator

The Catholic University of Korea

Collaborator

Ajou University School of Medicine

Collaborator

Pusan National University Hospital

Collaborator