Abdominal Massage After Colon Surgery for Cancer

NCT07713472 | Not Yet Recruiting

• 1 other identifier: 38RC26.0102
• Study Type: interventional
• Target: 225
• Locations: 1 country
• Sites: 1

Brief Summary

Postoperative ileus is a transient gastrointestinal dysmotility following abdominal surgery that leads to bloating, abdominal distention, visceral pain, nausea, vomiting, and delayed passage of flatus and stool. This paralytic state lasts longer when surgery involves the distal rather than the proximal digestive tract. Its incidence following colorectal surgery is between 10% and 30%. The main factors of postoperative ileus include age, predisposed constipation, method of anesthesia, type of surgical approach, perioperative analgesia, inflammatory reactions, and the psychopathology of the patient. Enhanced recovery after surgery (ERAS) provides patients with optimal means to counteract or minimize the deleterious effects of surgery, in particular toward minimizing postoperative ileus. Expert consensus among surgeons, anesthesiologists, physiotherapists, dieticians, and other team members has been reached that stated 24 clinical statements concerning preoperative, peroperative and postoperative periods that should be included in current rehabilitation programs in colorectal surgery. In China, massage, a 3000-year-old therapy guided by the theory of Yin and Yang, is widely used to treat various diseases. Chapelle and Bowe showed that abdominal massage reduced experimental postoperative ileus in a rat model and suggested that the effect was due to the attenuation of inflammation. Abdominal massage has not widely been applied after colorectal surgery. Due to the scarcity of literature on abdominal massage, it has never been considered to be part of ERAS recommendations in colorectal surgery. Nevertheless, massage involving profound maneuvering of the viscera through abdominal palpation and breathing has been used as part of the local postoperative protocol in our department for many years with interesting results, and no complication has been reported. To our knowledge, only one study has explored the effect of mechanical abdominal massage on the duration of ileus after colectomy. The aim of this prospective, multicenter randomized controlled trial (RCT) is to compare return of intestinal transit using the GI-2 criteria as defined by the time to first defecation and time to tolerance of solid food following the operation in two groups of patients following an ERAS protocol for colonic cancer surgery, one with and the other without early postoperative abdominal massage.

Conditions

Colonic Cancer

Keywords

Postoperative ileus; Surgery; Colonic cancer; Abdominal massage; Physiotherapy

Outcome Measures

Primary Outcomes (1)

• Evaluate the effectiveness of abdominal massage on the resumption of digestive transit after colonic resection surgery for cancer as part of ERAS protocol.

  The primary outcomes is the return of intestinal transit, as defined by the time to first defaecation and time to tolerance of solid food following the operation, calculated in hours from skin closure.

  Through study completion, 30 days

Study Arms (2)

abdominal massage and usual physiotherapeutic intervention

EXPERIMENTAL

the usual physiotherapeutic intervention (respiratory and walking exercices). Each patients will be treated following the ERAS Guideline. - At D + 1post-surgical: 1 - First lift with verticalization. 2 - A session with the Cliniflo® in a seated position. 3 - Walk at least 100 m with the help of the physiotherapist. At- D + 2 and D + 3 post-surgical Same session as on D + 1 with progressive increase in the walking perimeter. Add up and down stairs on D+ 3 In this experimental arm, a abdominal massage will be performed in addition to the usual physiotherapeutic intervention (respiratory and walking exercices). The sessions take place on D+1, D+2 and D+3 post-surgical The first session is performed at least 20 hours after surgery (incision begins) Never within an hour of a meal. The session is timed.

Other: ABDOMINAL MASSAGE; Other: Usual physiotherapeutic intervention

Usual physiotherapeutic intervention

ACTIVE COMPARATOR

the usual physiotherapeutic intervention (respiratory and walking exercises). Each patient will be treated following the ERAS Guideline. - At D + 1 post-surgical: 1 - First lift with verticalization. 2 - A session with the Cliniflo® in a seated position. 3 - Walk at least 100 m with the help of the physiotherapist. At- D+2 and D+3 post-surgical Same session as on D+1 with progressive increase in the walking perimeter. Add up and down stairs on D+ 3.

Other: Usual physiotherapeutic intervention

Interventions

ABDOMINAL MASSAGE OTHER

Abdominal massage is not widely applied amongst general surgery team and is not part of the recommendation. This technique refers to profound manœuvrers of visceras through abdominal palpation and breathing, and has been used as part of the local protocol of Grenoble Alps University Hospital for many years with satisfactory results. No complications have been reported.

abdominal massage and usual physiotherapeutic intervention

Usual physiotherapeutic intervention OTHER

the usual physiotherapeutic intervention (respiratory and walking exercices). Each patients will be treated following the ERAS Guideline. - At D + 1post-surgical: 1 - First lift with verticalization. 2 - A session with the Cliniflo® in a seated position. 3 - Walk at least 100 m with the help of the physiotherapist. At- D + 2 and D + 3 post-surgical Same session as on D + 1 with progressive increase in the walking perimeter. Add up and down stairs on D+ 3 In this experimental arm, a abdominal massage will be performed in addition to the usual physiotherapeutic intervention (respiratory and walking exercices). The sessions take place on D+1, D+2 and D+3 post-surgical The first session is performed at least 20 hours after surgery (incision begins) Never within an hour of a meal. The session is timed.

Usual physiotherapeutic intervention; abdominal massage and usual physiotherapeutic intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults programmed to undergo surgery involving right, transverse or left colectomy due to cancer with anastomosis, regardless the approach (laparoscopy.
• Laparotomy and Robot-assisted). Patients must be able to follow the colorectal surgery unit's ERAS protocol.

You may not qualify if:

• Patients required emergency surgery (obstruction or peritonitis),
• A stoma for whatever reason,
• Rectal cancer,
• BMI \> 40,
• Psychiatric disorders,
• An associated procedure, extensive resection,
• Pregnancy, deprivation of liberty by judicial or administrative decision, or being under legal protection and patients with a hierarchical link to the principal investigator.

Sponsors & Collaborators

• University Hospital, Grenoble: lead

Study Sites (1)

CHU Grenoble Alpes

Grenoble, 38043, France

Location

Related Publications (15)

• van Bree SH, Vlug MS, Bemelman WA, Hollmann MW, Ubbink DT, Zwinderman AH, de Jonge WJ, Snoek SA, Bolhuis K, van der Zanden E, The FO, Bennink RJ, Boeckxstaens GE. Faster recovery of gastrointestinal transit after laparoscopy and fast-track care in patients undergoing colonic surgery. Gastroenterology. 2011 Sep;141(3):872-880.e1-4. doi: 10.1053/j.gastro.2011.05.034. Epub 2011 May 26.

  PMID: 21699777 BACKGROUND

• Le Blanc-Louvry I, Costaglioli B, Boulon C, Leroi AM, Ducrotte P. Does mechanical massage of the abdominal wall after colectomy reduce postoperative pain and shorten the duration of ileus? Results of a randomized study. J Gastrointest Surg. 2002 Jan-Feb;6(1):43-9. doi: 10.1016/s1091-255x(01)00009-9.

  PMID: 11986017 BACKGROUND

• Vincent D, Barbut M, Fisher J, et al. Is there any benefit to immediate postoperative abdominal massage in colorectal surgery? La revue de kinésithérapie 2026; in press

  BACKGROUND

• Faucheron JL, Vincent D, Barbut M, Jacquet-Perrin I, Sage PY, Foote A, Quesada JL, Trilling B, Tidadini F. How long for gastrointestinal recovery following small bowel, right, or left colonic resection with anastomosis in a full fast-track recovery protocol? Int J Colorectal Dis. 2025 Apr 14;40(1):93. doi: 10.1007/s00384-025-04855-4.

  PMID: 40229620 BACKGROUND

• Faucheron JL, Vincent D, Barbut M, Jacquet-Perrin I, Sage PY, Foote A, Bellier A, Quesada JL, Tidadini F, Trilling B. Abdominal massage to prevent ileus after colorectal surgery. A single-center, prospective, randomized clinical trial: the MATRAC Trial. Tech Coloproctol. 2024 Mar 22;28(1):42. doi: 10.1007/s10151-024-02914-6.

  PMID: 38517591 BACKGROUND

• Wang Y, Xu J, Bao R, Li Z. Massage for gastrointestinal function among participants after abdominal surgery. A protocol for systematic review and meta-analysis. Medicine 21201.100(49):e28087 12. Chapelle SL, Bove GM. Visceral massage reduces postoperative ileus in a rat model. J Bodyw Mov Ther 2013;17:83-88

  BACKGROUND

• Trilling B, Sage PY, Faucheron JL. What is fast track multimodal management of colorectal cancer surgery in real life? Tech Coloproctol. 2018 May;22(5):401-402. doi: 10.1007/s10151-018-1799-9. Epub 2018 Jun 1. No abstract available.

  PMID: 29855815 BACKGROUND

• Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, Rockall TA, Young-Fadok TM, Hill AG, Soop M, de Boer HD, Urman RD, Chang GJ, Fichera A, Kessler H, Grass F, Whang EE, Fawcett WJ, Carli F, Lobo DN, Rollins KE, Balfour A, Baldini G, Riedel B, Ljungqvist O. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS(R)) Society Recommendations: 2018. World J Surg. 2019 Mar;43(3):659-695. doi: 10.1007/s00268-018-4844-y.

  PMID: 30426190 BACKGROUND

• Alfonsi P, Slim K, Chauvin M, Mariani P, Faucheron JL, Fletcher D; Working Group of Societe francaise d'anesthesie et reanimation (SFAR); Societe francaise de chirurgie digestive (SFCD). French guidelines for enhanced recovery after elective colorectal surgery. J Visc Surg. 2014 Feb;151(1):65-79. doi: 10.1016/j.jviscsurg.2013.10.006. Epub 2013 Dec 27.

  PMID: 24378143 BACKGROUND

• Mazzotta E, Villalobos-Hernandez EC, Fiorda-Diaz J, Harzman A, Christofi FL. Postoperative Ileus and Postoperative Gastrointestinal Tract Dysfunction: Pathogenic Mechanisms and Novel Treatment Strategies Beyond Colorectal Enhanced Recovery After Surgery Protocols. Front Pharmacol. 2020 Nov 24;11:583422. doi: 10.3389/fphar.2020.583422. eCollection 2020.

  PMID: 33390950 BACKGROUND

• Bragg D, El-Sharkawy AM, Psaltis E, Maxwell-Armstrong CA, Lobo DN. Postoperative ileus: Recent developments in pathophysiology and management. Clin Nutr. 2015 Jun;34(3):367-76. doi: 10.1016/j.clnu.2015.01.016. Epub 2015 Jan 31.

  PMID: 25819420 BACKGROUND

• Sugawara K, Kawaguchi Y, Nomura Y, Suka Y, Kawasaki K, Uemura Y, Koike D, Nagai M, Furuya T, Tanaka N. Perioperative Factors Predicting Prolonged Postoperative Ileus After Major Abdominal Surgery. J Gastrointest Surg. 2018 Mar;22(3):508-515. doi: 10.1007/s11605-017-3622-8. Epub 2017 Nov 8.

  PMID: 29119528 BACKGROUND

• Venara A, Neunlist M, Slim K, Barbieux J, Colas PA, Hamy A, Meurette G. Postoperative ileus: Pathophysiology, incidence, and prevention. J Visc Surg. 2016 Dec;153(6):439-446. doi: 10.1016/j.jviscsurg.2016.08.010. Epub 2016 Sep 23.

  PMID: 27666979 BACKGROUND

• Kronberg U, Kiran RP, Soliman MS, Hammel JP, Galway U, Coffey JC, Fazio VW. A characterization of factors determining postoperative ileus after laparoscopic colectomy enables the generation of a novel predictive score. Ann Surg. 2011 Jan;253(1):78-81. doi: 10.1097/SLA.0b013e3181fcb83e.

  PMID: 21233608 BACKGROUND

• Vather R, Trivedi S, Bissett I. Defining postoperative ileus: results of a systematic review and global survey. J Gastrointest Surg. 2013 May;17(5):962-72. doi: 10.1007/s11605-013-2148-y. Epub 2013 Feb 2.

  PMID: 23377782 BACKGROUND

MeSH Terms

Conditions

Colonic Neoplasms

Condition Hierarchy (Ancestors)

Colorectal Neoplasms; Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases

Central Study Contacts

Mihaela Barbut, MSc

CONTACT

00 334 76 76 48 02; mbarbut@chu-grenoble.fr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 26, 2026
• First Posted: July 20, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): December 31, 2027
• Study Completion (Estimated): August 31, 2028
• Last Updated: July 20, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)