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Implementation of Prehabilitation for Major Abdominal Surgery and Head and Neck Surgery: a Simplified Seven-Day Protocol

  • Original Article
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Journal of Gastrointestinal Surgery

Abstract

Purpose

The aim of this prospective trial was to assess the compliance of a prehabilitation protocol on post-operative outcome after major abdominal and head and neck surgery.

Methods

A single-arm, prospective 7-day intervention trial was approved by our local IRB for patients undergoing major abdominal and head-and-neck (H&N) surgery from 8/2018 to 3/2019. This was a 7-day intervention trial at the time of pre-admission testing to assess compliance for pulmonary, nutritional, and physical activity prior to surgery.

Results

Seventy-six patients were enrolled in this compliance with IS use that was 85%, with a median of 2200 cc (range 1500–2500cc), pre-operative nutritional drink (89.5%), and chlorhexidine gluconate use was 92%. Ambulation/step compliance was only 32 patients (44%), with median steps of 7500 (range 400–15,000). Compared with the non-prehabilitation patients, we found significant improvement in immediate post-operative mobility (OR 0.73, 95% CI 0.46–0.97, p = 0.04), and improvement in prevention of pulmonary morbidity (OR 0.82, 95% CI 0.23–1.18, p = 0.07) was observed in the prehabilitation group. No significant difference in overall infectious complications (18% vs 27%), surgical site infections (14% vs 22%), length of stay (median 6 days vs 6), or readmissions (18% vs 22%).

Conclusions

A simple 7-day prehabilitation protocol at the time of pre-admission testing is feasible with a high degree of compliance regardless of a patient’s disease type, education, or socioeconomic background.

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Authors and Affiliations

  1. Norton Cancer Institute, Louisville, KY, 40202, USA

    Jaclyn Moore

  2. Department of Surgery, Division of Surgical Oncology, University of Louisville, 315 E. Broadway-#311, Louisville, KY, 40202, USA

    Charles R. Scoggins, Prejesh Philips, Michael Egger & Robert C. G. Martin

  3. Department of Otolaryngology, University of Louisville, Louisville, KY, 40202, USA

    Paul Tennant & Jerod Little

Authors
  1. Jaclyn Moore
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  2. Charles R. Scoggins
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  3. Prejesh Philips
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  4. Michael Egger
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  5. Paul Tennant
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  6. Jerod Little
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  7. Robert C. G. Martin
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Contributions

Jaclyn Moore—conception of the work, data collection and analysis, drafting of manuscript, final approval, and agreement for the accountability of work.

Charles R Scoggins—conception of the work, data analysis, drafting of manuscript, final approval, and agreement for the accountability of work.

Prejesh Philips—conception of the work, data analysis, drafting of manuscript, final approval, and agreement for the accountability of work.

Michael Egger—conception of the work, data analysis, drafting of manuscript, final approval, and agreement for the accountability of work.

Paul Tennant—conception of the work, data analysis, drafting of manuscript, final approval, and agreement for the accountability of work.

Jerod Little—conception of the work, data analysis, drafting of manuscript, final approval, and agreement for the accountability of work.

Robert C.G. Martin, II—conception of the work, data analysis, drafting of manuscript, critical revision of content, final approval, and agreement for the accountability of work.

Corresponding author

Correspondence to Robert C. G. Martin.

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The authors declare that they have no conflict of interest.

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Moore, J., Scoggins, C.R., Philips, P. et al. Implementation of Prehabilitation for Major Abdominal Surgery and Head and Neck Surgery: a Simplified Seven-Day Protocol. J Gastrointest Surg 25, 2076–2082 (2021). https://doi.org/10.1007/s11605-020-04740-1

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  • DOI: https://doi.org/10.1007/s11605-020-04740-1

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