Surgical Prehabilitation in Abdominal Surgery (SPAS)

June 12, 2024 updated by: Universidad del Rosario

Surgical Prehabilitation of Patients Taken to Major Gastrointestinal Surgery.

Randomized clinical trial evaluating changes in functional capacity, postoperative complications and 30-day mortality in patients over 60 years of age undergoing major gastrointestinal surgery who participate in a multimodal prehabilitation program, compared to non-prehabilitated patients.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Introduction: A surgical procedure can have repercussions on the functionality and quality of life of patients, reducing their functional capacity by up to 40%; poor preoperative physical performance increases the risk of perioperative morbidity and mortality by 30% and prolongs functional recovery, increasing the hospital stay of the older adult. Prehabilitation is a preoperative intervention that improves the physical, psychological and nutritional condition of the patient to obtain a better postoperative recovery, mobility and functional independence.

Objective: To evaluate changes in functional capacity, postoperative complications and 30-day mortality in patients over 60 years of age undergoing major gastrointestinal surgery who participate in a multimodal prehabilitation program (exercise, nutrition and relaxation).

Methodology: Randomized clinical trial. Two study groups will be compared, an experimental group that will receive the educational intervention (multimodal prehabilitation program) and a control group that will continue with the usual management in the Hospital. The project activities will be carried out in Telehealth modality due to COVID-19 contagion containment measures.

Expected results: To encourage interprofessional work based on common goals with standardization of data and processes to improve physical condition and reduce post-surgical complications; to establish traceability of care, clinical and functional condition of the patient. It is intended to generate scientific evidence, integrate the research groups Méderi, Rehabilitation Sciences and Clinical Research.

Study Type

Interventional

Enrollment (Actual)

24

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • Distrito Capital
      • Bogota, Distrito Capital, Colombia
        • Hospital Universitario Mayor Méderi

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

60 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients scheduled by the General Surgery, Coloproctology and Hepatobiliary Surgery services
  • Cognitive ability to follow instructions,
  • Understand the material delivered (basic reading comprehension - through physical or digital media)
  • Perform physical exercise.
  • Aptitude to exercise according to the cardiovascular risk assessment performed by the treating physician.

Exclusion Criteria:

  • Patients scheduled for surgery from the emergency department
  • Patients with sepsis,
  • Patients with metastatic disease, without curative perspective
  • Patients with dysphagia for solid foods
  • Patients with incapacitating psychiatric or neurological illnesses
  • Patients with documented previous immunosuppression status (corticosteroid users in the 6 weeks prior to the randomisation) and/or HIV
  • Diabetic patients, with chronic renal disease, stage 4-5, with renal replacement therapy
  • Patients with heart failure decompensated, or that limits the physical exercise
  • Patients with dependent mobility
  • Patients with history of second primary neoplasm

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Multimodal Prehabilitation
Multimodal prehabilitation: exercise, nutrition and relaxation

Patients who will receive a multimodal prehabilitation program consisting of guided self-care activities at home that include exercise, nutrition and relaxation. Information Will be share by e health. Monitored by telephone daily during the first week and three times a week between the second and fourth week.

The final evaluation of the program will be performed one working day after the control appointment with surgery, which will be scheduled ten days after hospital discharge; and the satisfaction survey will be applied. At 30 days after surgery, a telephone follow-up will be made to inquire about complications and mortality. On that day, self-care recommendations will be given.

No Intervention: Standard of Care
Usual care group: advice of surgeons about self care

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
functional capacity
Time Frame: One to six weeks
Changes in the maximum capacity to carry and use oxygen measured with the 2-minute stationary gait test (2MSG)
One to six weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
postoperative complications
Time Frame: 30 days
Presence of morbidities, whether or not requiring hospital readmission, generated by the surgical procedure
30 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 23, 2022

Primary Completion (Actual)

June 22, 2023

Study Completion (Actual)

June 23, 2023

Study Registration Dates

First Submitted

September 15, 2021

First Submitted That Met QC Criteria

September 15, 2021

First Posted (Actual)

September 27, 2021

Study Record Updates

Last Update Posted (Actual)

June 14, 2024

Last Update Submitted That Met QC Criteria

June 12, 2024

Last Verified

June 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

  • CEI DVO005 1567-CV1324
  • B- 17-2020 (Other Grant/Funding Number: Centro de Investigaciones Mederi CIMED)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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