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Brief Title: Enhancing Fitness Before Pancreatic Surgery
Official Title: A Multimodal Approach to Improve Fitness and Surgical Outcomes for Patients Undergoing Pancreatic Resection
Study ID: NCT02940067
Brief Summary: This is a pilot study to investigate the effect of prehabilitation on patients undergoing elective surgery for pancreatic disease.
Detailed Description: Pancreatic surgery is high risk. The injury associated with surgery causes a stress response, comprising a variety of hormonal and metabolic effects. Patients undergoing pancreatic surgery experience one of the largest stress responses. Prehabilitation is the process of enhancing an individual's fitness, thereby improving tolerance to an upcoming physiological stress such as surgery. Studies involving prehabilitation have been shown to improve recovery after surgery and reduce complication rates. There are currently no published reports of prehabilitation involving patients undergoing pancreatic surgery. This research study will explore the effect of prehabilitation in these patients. Patients with pancreatic disease are some of the least fit surgical candidates due to the disease process. Exercise training can improve physical fitness before elective abdominal surgery and nutritional supplementation can also influence clinical course via different mechanisms. Patients with pancreatic disease are often malnourished for several reasons. We propose a multimodal approach to prehabilitation involving dietary and exercise interventions during a four-week period preceding elective surgery. Core data will be collected from cardiopulmonary exercise tests and blood tests (to assess insulin sensitivity), before and after prehabilitation. Secondary outcomes such as length of stay and complications will also be measured postoperatively.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
MATTU, Royal Surrey County Hospital, Guildford, Surrey, United Kingdom
Name: Tim Rockall, MD FRCS
Affiliation: MATTU, Royal Surrey County Hospital, Guildford, Surrey
Role: STUDY_CHAIR
Name: Mike Scott, FRCA FFICM
Affiliation: MATTU, Royal Surrey County Hospital, Guildford, Surrey
Role: STUDY_DIRECTOR
Name: Jason George, MA MRCS
Affiliation: MATTU, Royal Surrey County Hospital, Guildford, Surrey
Role: PRINCIPAL_INVESTIGATOR
Name: Martin Whyte, PhD FRCP
Affiliation: University of Surrey, Guildford, Surrey
Role: STUDY_DIRECTOR
Name: Joe Wainwright, BSc
Affiliation: University of Surrey and Surrey Human Performance Institute
Role: STUDY_DIRECTOR