Prehabilitation for Upper Gastrointestinal Tract Cancer Surgery

July 15, 2026 updated by: Chi-Wen Lin, Taichung Tzu Chi Hospital

The Effects of Multimodal Prehabilitation on Post-operative Recovery in Patients Undergoing Surgery for Upper Gastrointestinal Tract Cancer in Taiwan

Patients receiving surgery of upper gastrointestinal tract are often elderly, frail, malnourished, with poor functional reserve. They are associated with poor post-operative outcomes.

This multimodal treatment is associated with considerable morbidity and decline of patients' functional capacity due to sarcopenia and malnutrition. The poor outcomes can lead to a prolonged delayed recovery, hospital stay, and disability. The post-operative morbidity, especially cardiopulmonary complications, remains substantial. Prehabilitation before surgery can improve the functional capacity of patients to better withstand the stress of surgery.

In this perspective, prehabilitation has gained increasing popularity as it consists of various interventions that aim to optimize patient's preoperative condition. The rehabilitation programmes varies considerably. To maximise the benefits that can be accrued in the pre-operative period, prehabilitation programmes should be multimodal, including exercise and nutritional support. Increasing the maximal aerobic capacity by training before surgery, improves patients' functional capacity and should allow patients to better withstand the postoperative stress response.

Prehabilitation has been trialled in a range of surgical specialities, including colorectal, breast, hepatobiliary, bariatric, urological, thoracic, and orthopaedic surgery. In major abdominal surgery, multiple studies have indicated that prehabilitation improved preoperative functional capacity and postoperative outcomes. There is a large body of evidence for prehabilitation in patients undergoing intra-abdominal surgery, with studies reporting improvements in pre-operative cardiopulmonary fitness, and reductions in post-operative complications.

The data on prehabilitation after surgery for upper gastrointestinal tract are scarce and ambiguous and these studies often lacked a multimodal approach. The evidence of prehabilitation in Taiwan is scarce also. Surgery for upper gastrointestinal tract has a high morbidity and is associated with a prolonged recovery so there is significant potential to improve outcomes in this high-risk population. However, there are few studies of prehabilitation in surgery for upper gastrointestinal tract.

Hence, this study aimed to investigate the effect of a multimodal personalised, prehabilitation program on postoperative recovery and morbidity in patients undergoing surgery for upper gastrointestinal tract.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

40

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 Locations

  • Taiwan
      • Taichung, Taiwan
        • Taichung Tzu Chi Hospital
        • Contact:

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • aged ≥ 18 years
  • with a diagnosis of potentially resectable upper gastrointestinal tract cancer

Exclusion Criteria:

  • inability to give informed consent
  • non resectable disease
  • patients who declined surgery

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: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Prehabilitation
Other: Prehabilitation
A personalised, home-based exercise programme was prescribed by a physical therapist. In keeping with WHO guidelines, patients were prescribed a minimum of 600 MET minutes week-1, which equates to 150 min of moderate intensity activity, with the aim of increasing this to 1200 MET minutes week-1 (300 min of moderate intensity activity). Patients were prescribed a mixture of aerobic and strength exercises, each with a defined frequency, intensity, and duration. Patients received training on how to undertake the exercises and how to selfregulate the intensity using the Borg scale rating of perceived exertion (RPE), with a target range of 13 to 15 depending on the patient's medical history and type of exercise. A specialist dietitian undertook an assessment of nutritional status including identification and stratification of nutritional risk. A plan was agreed based on symptoms, dietary eating habits, and nutritional deficiencies.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Length of hospital stay
Time Frame: From enrollment to the end of treatment at 8 weeks
From enrollment to the end of treatment at 8 weeks
30-day readmission rate
Time Frame: From enrollment to the end of treatment at 12 weeks
From enrollment to the end of treatment at 12 weeks
Pulmonary complications
Time Frame: From enrollment to the end of treatment at 8 weeks
From enrollment to the end of treatment at 8 weeks
Anastomotic leakage rate
Time Frame: From enrollment to the end of treatment at 8 weeks
From enrollment to the end of treatment at 8 weeks
Severity (Clavien-Dindo) of complications
Time Frame: From enrollment to the end of treatment at 8 weeks
From enrollment to the end of treatment at 8 weeks

Collaborators and Investigators

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

Sponsor

Taichung Tzu Chi Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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 (Estimated)

August 1, 2026

Primary Completion (Estimated)

July 31, 2027

Study Completion (Estimated)

August 31, 2027

Study Registration Dates

First Submitted

July 7, 2026

First Submitted That Met QC Criteria

July 15, 2026

First Posted (Actual)

July 20, 2026

Study Record Updates

Last Update Posted (Actual)

July 20, 2026

Last Update Submitted That Met QC Criteria

July 15, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • TTCH2026

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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