Pancreatic Cancer, Pancreatitis, Chronic
Conditions
Keywords
prehabilitation, pancreatectomy, nutrition, exercise
Brief summary
This is a pilot study to investigate the effect of prehabilitation on patients undergoing elective surgery for pancreatic disease.
Detailed description
Pancreatic surgery is high risk. The injury associated with surgery causes a stress response, comprising a variety of hormonal and metabolic effects. Patients undergoing pancreatic surgery experience one of the largest stress responses. Prehabilitation is the process of enhancing an individual's fitness, thereby improving tolerance to an upcoming physiological stress such as surgery. Studies involving prehabilitation have been shown to improve recovery after surgery and reduce complication rates. There are currently no published reports of prehabilitation involving patients undergoing pancreatic surgery. This research study will explore the effect of prehabilitation in these patients. Patients with pancreatic disease are some of the least fit surgical candidates due to the disease process. Exercise training can improve physical fitness before elective abdominal surgery and nutritional supplementation can also influence clinical course via different mechanisms. Patients with pancreatic disease are often malnourished for several reasons. We propose a multimodal approach to prehabilitation involving dietary and exercise interventions during a four-week period preceding elective surgery. Core data will be collected from cardiopulmonary exercise tests and blood tests (to assess insulin sensitivity), before and after prehabilitation. Secondary outcomes such as length of stay and complications will also be measured postoperatively.
Interventions
OTHERMedEx
A combination of dietary and exercise interventions over four weeks before scheduled pancreatic surgery
Sponsors
University of Surrey
Royal Surrey County Hospital NHS Foundation Trust
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Elective pancreatic resection
Exclusion criteria
Contraindication to cardiopulmonary exercise testing: unstable cardiac disease, lower limb dysfunction Emergency surgery Ischaemic ECG during cardiopulmonary exercise test Allergy to fish oil or olive oil
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peak power - measured using cardiopulmonary exercise testing | Change in peak power between start and end of prehabilitation (4 weeks) | cardiopulmonary fitness |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of stay | From date of operation until date of discharge | Recovery |
| Complication rate | From date of operation until date of discharge | Morbidity |
| Insulin sensitivity - measured using the insulin clamp test | Change in insulin sensitivity between start and end of prehabilitation (4 weeks) | insulin sensitivity |
| Fatigue | Change in fatigue levels between start and end of prehabilitation (4 weeks) | Fatigue Levels |
| Well-being | Change in well-being scores between start and end of prehabilitation (4 weeks) | Sense of Well-being |
| Sleep | Change in sleep quality between start and end of prehabilitation (4 weeks) | Sleep Quality |
Countries
United Kingdom
Outcome results
None listed