Nurse-Led Prehabilitation Before Major Abdominal Cancer Surgery

Condition(s) studied

Investigational drug(s) / intervention(s)

Nurse-Led Multimodal Prehabilitation Program: A four-week program delivered by a trained oncology nurse from enrollment until the day before surgery, with a weekly nurse contact (in person or by phone) that reinforces the program and records adherence. Components: (1) Exercise: aerobic brisk walking 30 minutes, 5 days per week at moderate intensity (Borg rating of perceived exertion 11 to 14), resistance exercises 2 to 3 days per week, and daily breathing exercises, taught in a weekly supervised session and continued at home. (2) Nutrition: counseling guided by the Malnutrition Universal Screening Tool, protein target 1.2 to 1.5 g/kg/day, and oral nutritional supplements for medium or high risk, with counseling at baseline and weekly follow-up. (3) Psychological and educational: one preoperative education session about surgery and recovery plus weekly reinforcement, with relaxation and anxiety-reduction techniques. (4) Lifestyle: smoking and alcohol cessation advice where relevant, at baseline and weekly.

Study summary

Many people who have major planned surgery for abdominal cancer develop complications afterwards, which can prolong hospital stay and slow recovery. This study tests whether a four-week program led by a trained oncology nurse, started before surgery, reduces these complications. The program combines supervised and home exercise (walking, resistance and breathing exercises), nutrition counseling with protein targets and supplements when needed, education and relaxation techniques to reduce anxiety, and advice on stopping smoking and alcohol. Adults at one hospital will be randomly assigned, in equal numbers, to the program plus usual care or to usual care alone; 104 participants are planned. The main outcome is the Comprehensive Complication Index, a score from 0 to 100 that combines all complications within 30 days after surgery, graded by an assessor who does not know the group. Other outcomes include serious complications, distance walked in six minutes, quality of life, length of hospital stay, hospital readmission, time to first getting out of bed, and adherence to the program. In a qualitative part, 12 to 15 participants from the program group will be interviewed about their experiences, barriers and acceptability. Results from both parts will be combined to interpret the findings.

Eligibility

Primary outcome measure(s)

• Comprehensive Complication Index (CCI) — Postoperative day 30
  Comprehensive Complication Index, a single score for each patient from 0 (no complication) to 100 (death), calculated from all postoperative complications within 30 days after surgery graded by the Clavien-Dindo classification. Higher scores mean worse outcomes. Graded from the medical record by an assessor masked to group.

Trial sites (1)

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