Prehabilitation for Elective Major Abdominal Surgery

Nicolas DEMARTINES20 enrolled

Overview

Prehabilitation is a concept that challenges the traditional models of recovery by initiating the recovery process preoperatively. Improvement of physical capacity by means of prehabilitation may facilitate better recovery after surgery. The aim of the present study is to evaluate the impact of preoperative physical exercise training (prehabilitation) on postoperative recovery and clinical outcomes after major abdominal surgery.

Major abdominal surgery is a great stressor to patients and causes large physiological changes, leads to tissue trauma, immobility, psychological distress and reduced quality of life. Physical capacity appears to be an important predictor for postoperative recovery after major abdominal surgery. Prehabilitation is a concept that challenges the traditional models of recovery by initiating the recovery process preoperatively. Improvement of physical capacity by means of prehabilitation may facilitate better recovery after surgery. More specifically prior to major abdominal surgery, preoperative exercise therapy is associated with improved physical fitness of patients, but whether or not this results in fewer complications or faster convalescence remains unclear. The aim of the present study is to evaluate the impact of preoperative physical exercise training (prehabilitation) on postoperative recovery and clinical outcomes after major abdominal surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

Conditions

Prehabilitation

Interventions

PrehabilitationOTHER

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: Elective major abdominal surgery: * Esophagus, stomach * Liver, pancreas * Small intestine, colon, rectum * Benign or malignant disease * Other intra-abdominal open or laparoscopic surgery lasting\> 2 hours * Delay of 3 weeks between consultation and surgery Exclusion Criteria: * Patient \< 18 years, consent not obtained * Coronary artery disease (≥ stage III according to CCS) * Heart disease (≥ stage III according to NYHA) * Uncontrolled cardiac arrhythmias * COPD (GOLD stage ≥ III) * Physical inability to ride a bike * Orthopedic surgery in the last 6 weeks

Locations (1)

Department of Visceral Surgery, University Hospital Center

Lausanne, Switzerland

Outcomes

Primary Outcomes

Postoperative morbidity

Comprehensive Complication Index (CCI)

Time frame: Up to 30 postoperative days

Secondary Outcomes

Postoperative most severe complication

Clavien classification

Time frame: Up to 30 postoperative days

Length of stay

From the day of hospitalization to the exit

Time frame: Up to 30 postoperative days

Readmission rates

Any readmission to the hospital

Time frame: Up to 30 postoperative days

Exercise capacity

Exercise testing on a cycloergometer(VO2 max)

Time frame: At 3 and 1 week preoperatively

Life satisfaction

Specific questionnaire (EORTC:European Organisation for Research and Treatment of Cancer)

Time frame: At 3 and 1 week preoperatively, then at 4 and 8 weeks postoperatively

Biological inflammatory response

C-reactiv protein (CRP) measure

Time frame: Up to 3 postoperative days

Exercise capacity

Time up and go test

Time frame: At 3 and 1 week preoperatively, then at 4 and 8 weeks postoperatively

Walking capacity

6 minutes Walking Test

Data from ClinicalTrials.gov

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