This study aims to evaluate the effectiveness of prehabilitation strategies in patients undergoing laparoscopic sleeve gastrectomy (LSG). The study compares a group receiving prehabilitation (including exercise, nutritional, and psychological support) with a control group receiving routine care. The primary goal is to determine if prehabilitation improves postoperative recovery, enhances weight loss, improves quality of life, and reduces complications.
Obesity is a significant global health issue, and laparoscopic sleeve gastrectomy (LSG) is a common surgical treatment. However, the procedure is invasive and can cause physical and psychological stress, impacting postoperative recovery. Prehabilitation, a process of enhancing a patient's functional capacity before surgery, has shown promise in various surgical fields. This study investigates a "triad prehabilitation management mode," incorporating psychological intervention, nutritional support, and exercise training for patients undergoing LSG. This prospective, randomized controlled trial enrolled 120 patients assigned to either a prehabilitation group or a control group. The prehabilitation group received a structured program of exercise, nutritional guidance, and psychological support for 5-7 days before surgery, in addition to routine care. The control group received routine care only. The study hypothesizes that the prehabilitation strategy will lead to faster gastrointestinal function recovery, better weight loss outcomes, improved quality of life, and a lower rate of postoperative complications compared to routine care.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
120
A structured psychological intervention aimed at alleviating preoperative anxiety. It included one-on-one counseling, providing detailed information about the surgical procedure, introducing relaxation techniques and music therapy, and sharing success stories from previous patients to boost confidence. Support was provided via phone or WeChat video by a qualified psychological counselor.
A daily guided exercise regimen including two components: 1) General physical conditioning consisting of at least 40 minutes of moderate-intensity aerobic and resistance training (e.g., brisk walking, jogging, cycling). 2) Respiratory function training consisting of abdominal breathing (5 times/hour) and balloon-blowing exercises (10 times/day). Patient adherence was monitored daily via a WeChat group.
The First Hospital of Hebei Medical University
Shijiazhuang, Hebei, China
Time to recovery of bowel motility
Time in days from surgery until the first audible bowel sounds.
Time frame: Perioperative
Time to first flatus
Time in hours/days from surgery until the patient's first passage of flatus.
Time frame: Perioperative
Time to first bowel movement
Time in days from surgery until the patient's first bowel movement.
Time frame: Perioperative
Time to first eating
Time in hours/days from surgery until the patient starts clear liquids.
Time frame: Perioperative
Duration of hospital stay
Total length of stay in the hospital, measured in days.
Time frame: Perioperative
Change in Body Mass Index (BMI)
Change in BMI (kg/m²) from baseline to 6 months post-surgery.
Time frame: Baseline and 6 months post-surgery
Change in Waist Circumference
Change in waist circumference (cm) from baseline to 6 months post-surgery.
Time frame: Baseline and 6 months post-surgery
Quality of Life Score
Change in score on the Medical Outcomes Study Short Form 36 (MOS SF-36) Health Survey. The scale assesses eight dimensions, with higher scores indicating better quality of life.
Time frame: Baseline and 6 months post-surgery
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Focused on optimizing preoperative habits. Nutritional guidance involved a high-protein, high-vitamin diet with six smaller, frequent meals per day to adapt to post-surgery conditions. Lifestyle guidance included advising smoking and alcohol cessation and ensuring 6-8 hours of sleep per night. Daily dietary and sleep status were reported and monitored via a WeChat group.
Consisted of standard care practices before, during, and after surgery. Preoperative care included health education and fasting instructions. Intraoperative care included body temperature maintenance and vital signs monitoring. Postoperative care included 12-hour ECG monitoring, gradual reintroduction of a clear liquid diet 24 hours post-surgery, encouragement of early mobilization, and standard nursing for catheters and wounds.
Incidence of Postoperative Complications
The percentage of patients experiencing complications such as abdominal distention, bleeding, and anastomotic leak.
Time frame: Perioperative and 6 months post-surgery