Enhanced Recovery Versus Standard Care After Emergency Abdominal Surgery in Patients Requiring Emergency Laparotomy

Summary

This study aims to compare an Enhanced Recovery After Surgery (ERAS) protocol with conventional postoperative care in adults undergoing emergency laparotomy for intestinal obstruction or intestinal perforation.

The main question this study aims to answer is:

• Does the ERAS protocol reduce surgical site infections compared with conventional care after emergency laparotomy?

Researchers will also compare other recovery outcomes between the two groups, including length of hospital stay, occurrence of paralytic ileus (temporary loss of bowel function), time to first bowel movement, and time to start taking fluids by mouth after surgery.

A total of 102 participants will be enrolled and randomly assigned to one of two groups. One group will receive postoperative care according to the ERAS protocol, while the other group will receive conventional postoperative care. All participants will undergo emergency laparotomy using standard surgical and anesthetic techniques.

Participants will:

* Undergo emergency laparotomy for intestinal obstruction or intestinal perforation.
* Receive either ERAS-based postoperative care or conventional postoperative care.
* Be monitored during their hospital stay for recovery and postoperative complications.
* Be assessed for bowel function recovery, ability to tolerate oral fluids, and length of hospital stay.
* Be followed for 30 days after surgery to determine whether a surgical site infection develops.

The researchers hypothesize that patients managed with the ERAS protocol will have a lower frequency of surgical site infections and improved postoperative recovery compared with those receiving conventional care.

Conditions

• Emergency Laparotomy
• Intestinal Obstruction
• Intestinal Perforation
• Enhanced Recovery After Surgery (ERAS) Protocol
• Surgical Site Infection (SSI)
• Postoperative Recovery

Interventions

PROCEDURE

Enhanced Recovery After Surgery

A standardized multimodal perioperative care pathway applied to patients undergoing emergency laparotomy. The protocol includes pre-defined components for preoperative optimization, intraoperative management, and postoperative care. Postoperative elements include early mobilization, early initiation of oral fluids and diet, optimized multimodal analgesia, early removal of tubes/drains when appropriate, and structured fluid management.

PROCEDURE

Conventional Postoperative Care

Standard postoperative management routinely practiced in the surgical unit for patients undergoing emergency laparotomy. Care includes traditional postoperative monitoring, routine analgesia, delayed initiation of oral intake, standard mobilization practices, and conventional fluid and supportive management.

Sponsors & Collaborators

• Recep Tayyip Erdogan Hospital Pakistan - Muzaffargarh

  lead OTHER

Principal Investigators

• Muhammad I Seerat, FCPS · Recep tayyip Erdogan Hospital Muzaffargarh

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-05-01

Primary Completion

2025-10-30

Completion

2025-10-30

Countries

• Pakistan

Study Locations