Prehabilitation for patients undergoing endoscopic submucosal dissection: a randomized controlled trial

作者：Biyun Jiang, Shengdi Lu, Yiling Yan, Ruixin Wang, Ming Xu, Lihua Huang, Yun Shen · 发表于：BMC Gastroenterology · 年份：2025 · DOI：10.1186/s12876-025-04418-5 · 被引用次数：2 · 研究领域：Gastric Cancer Management and Outcomes、Enhanced Recovery After Surgery、Stoma care and complications

BACKGROUND: Endoscopic submucosal dissection (ESD) is a minimally invasive therapy for early gastrointestinal neoplasms, but patients may experience reduced functional capacity and delayed recovery post-procedure. Prehabilitation, has shown benefits in major surgery by improving physical fitness and recovery. We hypothesized that a structured prehabilitation regimen before ESD would enhance postoperative functional recovery and patient outcomes compared to standard care. METHODS: Single-center, assessor-blinded randomized controlled trial of 100 adults undergoing elective ESD, randomized to 4-week prehabilitation (supervised aerobic/resistance training 3×/week, individualized nutrition with protein supplementation, and psychological support) or usual care (standard instructions without structured exercise or nutrition). The primary outcome was change in six-minute walk distance (6MWD) from baseline to 1 month. Secondary outcomes included handgrip strength, quality of life (SF-36), psychological health (HADS), postoperative complications, length of stay, and 90-day readmissions. RESULTS: Baseline characteristics were similar between groups. At 1-month post-ESD, six-minute walk distance had decreased in both groups with no significant between-group difference (mean change from baseline - 40.9 m in prehabilitation vs. - 53.3 m in controls, p = 0.439). By 3 months, the prehabilitation group surpassed their baseline walking distance (18.9 m), whereas controls remained below baseli...