Abdominal massage to prevent ileus after colorectal surgery. A single-center, prospective, randomized clinical trial: the MATRAC Trial.
Study Goal
The researchers aimed to determine whether abdominal massage after colorectal surgery with anastomosis and no stoma could accelerate the return of intestinal transit.
Results Summary
The study found no significant difference in the time to first passage of flatus or other secondary endpoints between the ERAS group and the ERAS plus massage group, indicating no advantage of abdominal massage in reducing postoperative ileus symptoms.
Population
Patients scheduled to undergo intestinal resection following an ERAS protocol.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
abdominal massage | no change | prevent or even reduce symptoms of postoperative ileus | patients scheduled to undergo intestinal resection and follow an ERAS protocol | - | failed to demonstrate any advantage | #1 |
abdominal massage | no change | time to passage of the first flatus | patients scheduled to undergo intestinal resection and follow an ERAS protocol | 1065 versus 1389 min | no significant difference | #2 |
abdominal massage | no change | time of the first bowel motion | patients scheduled to undergo intestinal resection and follow an ERAS protocol | - | No statistically significant intergroup difference was noted | #3 |
abdominal massage | no change | maximal pain | patients scheduled to undergo intestinal resection and follow an ERAS protocol | - | No statistically significant intergroup difference was noted | #4 |
abdominal massage | no change | 30 day complications | patients scheduled to undergo intestinal resection and follow an ERAS protocol | - | No statistically significant intergroup difference was noted | #5 |
abdominal massage | no change | complications due to massage | patients scheduled to undergo intestinal resection and follow an ERAS protocol | - | No statistically significant intergroup difference was noted | #6 |
abdominal massage | no change | anxiety score given by the Hospital Anxiety and Depression (HAD) questionnaire | patients scheduled to undergo intestinal resection and follow an ERAS protocol | - | No statistically significant intergroup difference was noted | #7 |
abdominal massage | no change | quality of life assessed by the EQ-5D-3L questionnaire | patients scheduled to undergo intestinal resection and follow an ERAS protocol | - | No statistically significant intergroup difference was noted | #8 |
BACKGROUND: There is scarce literature on the effect of mechanical abdominal massage on the duration of ileus after colectomy, particularly in the era of enhanced recovery after surgery (ERAS). The aim of this study was to determine whether abdominal massage after colorectal surgery with anastomosis and no stoma helps toward a faster return of intestinal transit. METHODS: This study was a superiority trial and designed as a prospective open-label, single-center, randomized controlled clinical trial with two parallel groups. Patients scheduled to undergo intestinal resection and follow an ERAS protocol were randomly assigned to either the standard ERAS group or the ERAS plus massage group. The primary endpoint was the return of intestinal transit, defined as the first passage of flatus following the operation. Secondary endpoints included time of the first bowel motion, maximal pain, 30 day complications, complications due to massage, anxiety score given by the Hospital Anxiety and Depression (HAD) questionnaire, and quality of life assessed by the EQ-5D-3L questionnaire. RESULTS: Between July 2020 and June 2021, 36 patients were randomly assigned to the ERAS group or the ERAS plus massage group (n = 19). Patients characteristics were comparable. There was no significant difference in time to passage of the first flatus between the ERAS group and the ERAS plus abdominal massage group (1065 versus 1389 min, p = 0.274). No statistically significant intergroup difference was noted for the secondary endpoints. CONCLUSION: Our study, despite its limitations, failed to demonstrate any advantage of abdominal massage to prevent or even reduce symptoms of postoperative ileus after colorectal surgery. TRIAL REGISTRATION NUMBER: 38RC20.021.