Prehabilitation
Conditions
Brief summary
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.
Detailed description
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.
Interventions
OTHERPrehabilitation
Sponsors
Nicolas DEMARTINES
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative morbidity | Up to 30 postoperative days | Comprehensive Complication Index (CCI) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of stay | Up to 30 postoperative days | From the day of hospitalization to the exit |
| Readmission rates | Up to 30 postoperative days | Any readmission to the hospital |
| Exercise capacity | At 3 and 1 week preoperatively | Exercise testing on a cycloergometer(VO2 max) |
| Life satisfaction | At 3 and 1 week preoperatively, then at 4 and 8 weeks postoperatively | Specific questionnaire (EORTC:European Organisation for Research and Treatment of Cancer) |
| Postoperative most severe complication | Up to 30 postoperative days | Clavien classification |
| Walking capacity | At 3 and 1 week preoperatively, then at 4 and 8 weeks postoperatively | 6 minutes Walking Test |
| Happiness | At 3 and 1 week preoperatively, then at 4 and 8 weeks postoperatively | Specific questionnaire (EMMBEP questionnaire) |
| Nutritional response | Up to 3 postoperative days | Albumin measure |
| Biological inflammatory response | Up to 3 postoperative days | C-reactiv protein (CRP) measure |
Countries
Switzerland
Outcome results
None listed