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Prehabilitation for Esophageal Resection Surgery

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ClinicalTrials.gov Identifier: NCT01666158
Recruitment Status : Completed
First Posted : August 16, 2012
Last Update Posted : March 21, 2018
Sponsor:
Information provided by (Responsible Party):
Franco Carli, McGill University Health Center

Brief Summary:

Consenting patients scheduled for esophageal resection surgery will be randomized to receive standard nutrition counseling (including nutritional supplements as needed) or standard nutrition counseling and exercise 4 weeks before surgery and 8 weeks after surgery.

It is hypothesized that, compared with the group receiving nutrition alone, the addition of physical exercise to nutrition starting before surgery and continuing for 8 weeks after surgery will have a significantly greater impact on functional walking capacity during the prehabilitation period and during the postoperative period, and on the incidence of postoperative pulmonary complications.


Condition or disease Intervention/treatment Phase
Esophageal Cancer Surgery Behavioral: Exercise Not Applicable

Detailed Description:

A randomized controlled study in patients undergoing esophageal resection for cancer to determine the impact of multimodal prehabilitation on functional exercise capacity and postoperative pulmonary complications. Patients who accept to be enrolled in the study will be randomized to receive either a standard nutritional intervention (including supplements as needed) as per current institution policy or standard nutritional intervention (including supplements as needed) combined with a physical exercise program before and after surgery.

Specific aims

The aims of this research project are the following:

  1. To determine the extent in which a multimodal prehabilitation regimen optimizes functional recovery in patients suffering from esophageal cancer and the incidence of postoperative pulmonary complications.
  2. To understand further which measures of immediate surgical recovery are sensitive to prehabilitation interventions, and predict change in later outcome measures.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 68 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Health Services Research
Official Title: Prehabilitation to Enhance Postoperative Functional Capacity Following Esophageal Resection
Study Start Date : January 2013
Actual Primary Completion Date : July 2017
Actual Study Completion Date : July 2017

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Active Comparator: Exercise
Patients in this group will follow standard MUHC protocol of nutritional counseling and supplementation as needed in order to maintain caloric and protein requirements in the preoperative period. Additionally, these patients will be given a specific physical exercise program before and after surgery by kinesiologist.
Behavioral: Exercise
The exercise component will consist of 20 min of general exercise training, 3 days per week, alternating between aerobic and resistance training. The exercise program will be individualized based upon the baseline fitness test (according to the American College of Sport Medicine, ACMS, standard) and will include: a 5 min warm-up, either 25 min of aerobic exercise (starting at 30- 40 of heart rate reserve, HRR), or 25 min of resistance training (5 exercises targeting major muscle groups performed at an intensity of 8-12 repetition maximum), and a 5 min cool-down.

No Intervention: Standard nutrition counselling
Patients in this group will follow standard MUHC protocol of nutritional counseling and supplementation as needed in order to maintain caloric and protein requirements in the preoperative period. This group will receive general instructions on exercises (breathing, ankle rotation) to be done during hospital stay by kinesiologist.



Primary Outcome Measures :
  1. 6 minute walk test (6MWT) [ Time Frame: up to 8 weeks after surgery ]
    The 6MWT evaluates the ability of an individual to maintain a moderate level of physical activity over a time period reflective of the activities of daily living. Subjects are instructed to walk back and forth, in a 20 m stretch of hallway, for six minutes, at a pace that would make them tired by the end of the walk; encouragement and feedback are given according to published guidelines.



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • 18 and older
  • referred electively for resection of malignant esophageal lesion

Exclusion Criteria:

  • American Society of Anesthesiologists (ASA) health status class 4-5
  • Dementia and psychosis
  • Disabling orthopedic and neuromuscular disease
  • Severe cardiac abnormalities
  • Severe end-organ disease such as cardiac failure (New York Heart Association classes I-IV)
  • COPD
  • renal failure (creatinine > 1.5 mg/dl, and hepatic failure ALT and AST >50% over the normal range)
  • Morbid obesity (BMI >30)
  • Anemia (hematocrit < 30 %, haemoglobin <10g/dl, albumin < 25mg/dl)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01666158


Locations
Canada, Quebec
Montreal General Hospital
Montreal, Quebec, Canada, H3G 1A4
Sponsors and Collaborators
Franco Carli
Investigators
Principal Investigator: Franco Carli, M.D. Montreal University Health Centre

Publications of Results:
Responsible Party: Franco Carli, Professor, McGill University Health Center
ClinicalTrials.gov Identifier: NCT01666158     History of Changes
Other Study ID Numbers: 12-171-SDR
First Posted: August 16, 2012    Key Record Dates
Last Update Posted: March 21, 2018
Last Verified: September 2016

Additional relevant MeSH terms:
Esophageal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Head and Neck Neoplasms
Digestive System Diseases
Esophageal Diseases
Gastrointestinal Diseases