Lung Cancer Clinical Trial
Official title:
The Impact of Trimodal Prehabilitation Strategy on Perioperative Functional Capability and Prognosis of Patients Undergoing Thoracoscopic Lobectomy for Lung Cancer:a Randomized Controlled Trail
The process of enhancing an individual's functional capacity to optimize physiologic reserves before an operation to withstand the stress of surgery has been coined prehabilitation. This is a prospective randomized controlled trail, designed to explore if the patients who take thoracoscopic lobectomy for lung cancer will benefit from family trimodal prehabilitation strategy. Trimodal prehabilitation includes exercise, nutrition supplement and physiology management preoperatively. It starts from the day that patients decide to take the surgery until the day before surgery, lasting 2~3 week in our hospital. And we follow-up patients until 8 weeks after surgery to investigate if trimodal prehabilitation strategy can improve the postoperative functional recovery,reduce complications and improve prognosis.
This is a prospective randomized controlled trail, which focus on the impact of family
prehabilitaiton strategy on the patients undertaking thoracoscopic lobectomy for lung cancer.
The process of enhancing an individual's functional capacity to optimize physiologic reserves
before an operation to withstand the stress of surgery has been coined prehabilitation. It
has been confirm that trimodal prehabilitation strategy including exercise, diet and
psychology guidance could improve postoperative functional recovery after surgery for
patients undergoing colorectal resection. But there has been no research about the impact of
trimodal prehabilitation in other operations.
Although many clinical studies have confirmed that preoperative exercise for patients
undergoing lung cancer surgery is safe and useful, but so far there are few studies
investigated perioperative functional capability in population undergoing thoracoscopic
lobectomy. And no study extends preoperative exercise to trimodal prehabilitation adding
nutritional and psychological management. In addition, the prehabilitation strategy in
previous studies usually takes 4~8 weeks. However, patient suspected of malignant tumor often
wouldn't wait for such a long period. We therefore designed this study to investigate if a
2~3 week family trimodal prehabilitation strategy benefits the patients undergoing
thoracoscopic lobectomy for lung caner.
There will be 100 patients awaiting elective thoracoscopic lobectomy for primary lung cancer
recruited in this research at Peking Union Medical College Hospital. After informed consent
was obtained, the patients will be divided into two groups randomly, the prehibilitation
group and control group.
The prehabilitation group will receive an individual trimodal prehabilitation strategy after
a complete assessment, including physical exercise, nutritional optimization, and
psychological therapy, as well as conventional guidance. The length of prehabilitation was
determined by the waiting time till surgery alone. The control group will receive the
conventional guidance, including preoperative anesthesia assessment, drug treatment
recommendations for chronic disease, quit smoking and abstinence. Both of the groups are also
provided some useful information about anesthesia and surgery process.
The functional capability will be examined for both groups at several time points (baseline,
the day before surgery, 1st, 2nd and 3rd day postoperatively, 4 weeks postoperatively and 8
weeks postoperatively) The primary end point is functional walking capacity as measured by
the 6 minutes walking distance (6MWD) 4 weeks postoperatively. The secondary end points
include lung function improvement (baseline vs. preoperative) , self-reported physical
activity, health-related quality of life scales and prognosis information (postoperative
complications, length of hospital stay, ICU stay time, hospitalization expenses, etc.).
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