Effect of home-based prehabilitation on postoperative complications after surgery for gastric cancer: randomized clinical trial.
| Title: | Effect of home-based prehabilitation on postoperative complications after surgery for gastric cancer: randomized clinical trial. |
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| Authors: | Bausys A; Department of Abdominal Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.; Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Centre for Visceral Medicine and Translational Research, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Luksta M; Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Anglickiene G; Department of Medical Oncology, National Cancer Institute, Vilnius, Lithuania.; Maneikiene VV; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine of the Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Kryzauskas M; Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Rybakovas A; Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Dulskas A; Department of Abdominal Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.; Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Kuliavas J; Department of Abdominal Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.; Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Stratilatovas E; Department of Abdominal Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.; Macijauskiene L; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine of the Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Simbelyte T; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine of the Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Celutkiene J; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine of the Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Jamontaite IE; Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Cirtautas A; Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Lenickiene S; Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Petrauskiene D; Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Cikanaviciute E; Centre of Hepatology, Gastroenterology, and Nutrition, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.; Gaveliene E; Centre of Hepatology, Gastroenterology, and Nutrition, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.; Klimaviciute G; National Cancer Institute, Vilnius, Lithuania.; Rauduvyte K; National Cancer Institute, Vilnius, Lithuania.; Bausys R; Department of Abdominal Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.; Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Strupas K; Department of Abdominal Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.; Centre for Visceral Medicine and Translational Research, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. |
| Source: | The British journal of surgery [Br J Surg] 2023 Nov 09; Vol. 110 (12), pp. 1800-1807. |
| Publication Type: | Randomized Controlled Trial; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press on behalf of BJS Foundation Ltd Country of Publication: England NLM ID: 0372553 Publication Model: Print Cited Medium: Internet ISSN: 1365-2168 (Electronic) Linking ISSN: 00071323 NLM ISO Abbreviation: Br J Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2021- : [Oxford] : Oxford University Press on behalf of BJS Foundation Ltd.; Original Publication: [Bristol, England : Baltimore : John Wright & Sons ; Williams & Wilkins Co. |
| MeSH Terms: | Stomach Neoplasms*/surgery ; Preoperative Exercise*; Postoperative Complications/prevention & control ; Humans ; Quality of Life ; Preoperative Care |
| Abstract: | Background: Recent studies have demonstrated that prehabilitation improves patients' physical fitness but its impact on postoperative morbidity remains unclear. This study aimed to assess the effect of personalized, multimodal, semisupervised, home-based prehabilitation on postoperative complications after surgery for gastric cancer.; Methods: This RCT was conducted at two centres in Lithuania. Patients (aged at least18 years) with gastric cancer scheduled to undergo elective primary surgery or surgery after neoadjuvant chemotherapy for gastric cancer were randomized (1 : 1) to prehabilitation or standard care. Prehabilitation included exercise interventions focused on endurance, respiratory muscle strength, stretching, and resistance training as well as nutritional and psychological support. The primary outcome was the proportion of patients with postoperative complications within 90 days after surgery. Secondary outcomes included 90-day mortality rate, physical condition, fitness level, nutritional status, quality of life, anxiety and depression level, and proportion of patients completing neoadjuvant chemotherapy.; Results: Between February 2020 and September 2022, 128 participants were randomized to prehabilitation (64) or standard care (64), and 122 (prehabilitation 61, control 61) were analysed. The prehabilitation group had increased physical capacity before the operation compared with baseline (mean 6-min walk test change +31 (95 per cent c.i. 14 to 48) m; P = 0.001). The prehabilitation group had a decreased rate of non-compliance with neoadjuvant treatment (risk ratio (RR) 0.20, 95 per cent c.i. 0.20 to 0.56), a 60 per cent reduction in the number of patients with postoperative complications at 90 days after surgery (RR 0.40, 0.24 to 0.66), and improved quality of life compared with the control group.; Conclusion: Prehabilitation reduced morbidity in patients who underwent gastrectomy for gastric cancer.; Registration Number: NCT04223401 (http://www.clinicaltrials.gov).; (© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.) |
| Molecular Sequence: | ClinicalTrials.gov NCT04223401 |
| Entry Date(s): | Date Created: 20230926 Date Completed: 20231113 Latest Revision: 20231114 |
| Update Code: | 20260130 |
| DOI: | 10.1093/bjs/znad312 |
| PMID: | 37750588 |
| Database: | MEDLINE |
Randomized Controlled Trial; Journal Article