Prehabilitation Before Gastrointestinal Cancer Surgery: Protocol for an Implementation Study

Area of Science:

• Oncology
• Surgical Care
• Implementation Science

Background:

• Colorectal and upper gastrointestinal cancers are treated with surgery.
• Poor preoperative status negatively impacts surgical outcomes.
• Prehabilitation aims to enhance patient reserves before surgery.

Purpose of the Study:

• To implement a multimodal prehabilitation program into standard care for gastrointestinal cancer patients.
• To assess the program's impact on functional capacity, nutritional status, psychological well-being, and surgical outcomes.

Main Methods:

• An implementation study using a pre-post design.
• Inclusion of patients with gastrointestinal cancer scheduled for curative surgery.
• Evaluation using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.

Main Results:

• Protocol approved in December 2019; recruitment spanned January 2020 to December 2021.
• Recruitment adapted for COVID-19 with remote/telehealth options.
• 77 participants recruited over 16 months.

Conclusions:

• Prehabilitation offers a strategy to optimize functional capacity and surgical results.
• This study informs the integration of prehabilitation into routine healthcare.
• Adaptive delivery models, including telehealth, are key for successful implementation.