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Abdominal massage to prevent ileus after colorectal surgery. A single-center, prospective, randomized clinical trial: the MATRAC Trial

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Abstract

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.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Dr. Matthieu Roustit (Grenoble Clinical Investigation Center) for his valuable advice on methodology, the anesthetists, the dieticians, and the colorectal unit nurses.

Funding

Alpes University Hospital internal call for tender Grenoble.

Author information

Authors and Affiliations

  1. University Grenoble Alpes, CNRS, Grenoble INP, TIMC, UMR 5525, VetAgro Sup, 38000, Grenoble, France

    Jean-Luc Faucheron & Bertrand Trilling

  2. Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France

    Jean-Luc Faucheron, Damien Vincent, Mihaela Barbut, Isabelle Jacquet-Perrin, Pierre-Yves Sage, Alison Foote, Fatah Tidadini & Bertrand Trilling

  3. Clinical Pharmacology Unit, INSERM CIC1406, Grenoble Alpes University Hospital, Grenoble, France

    Alexandre Bellier & Jean-Louis Quesada

Authors
  1. Jean-Luc Faucheron
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  2. Damien Vincent
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  3. Mihaela Barbut
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  4. Isabelle Jacquet-Perrin
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  5. Pierre-Yves Sage
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  6. Alison Foote
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  7. Alexandre Bellier
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  9. Fatah Tidadini
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  10. Bertrand Trilling
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Contributions

Conceptualization: JLF and DV. Methodology: JLF, DV, AF, JLQ, FT, and BT. Formal analysis: JLF, DV, MB, IJP, JLQ, and BT. Investigation: JLF, DV, FT, and BT. Data curation: JLF, DV, MB, IJP, PYS, and BT. Writing the original draft: JLF, DV, AF (English native), and BT. Writing: review and editing: all authors. Supervision: JLF. Project administration: FT. Funding acquisition: DV and FT.

Corresponding author

Correspondence to Jean-Luc Faucheron.

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Competing interests

The authors declare no competing interests.

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethics approval and consent to participate

The study was approved by the institutional review board on 13 March 2020 (IRB no. 2020-A00175-34) and was registered with the Clinical Trials Registry (38RC20.021). All included patients signed a study specific written informed consent form prior to inclusion in the trial. The university hospital took out an assurance policy covering any harm due to trial participation. The university hospital had signed a contract with the national data privacy agency (CNIL) concerning respect of data privacy regulations.

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Faucheron, JL., Vincent, D., Barbut, M. et al. Abdominal massage to prevent ileus after colorectal surgery. A single-center, prospective, randomized clinical trial: the MATRAC Trial. Tech Coloproctol 28, 42 (2024). https://doi.org/10.1007/s10151-024-02914-6

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