Effects of A Preoperative Exercise Training Program on Postoperative Pulmonary Complications and Exercise Capacity In Patients With Abdominal Cancer: A Systematic Review Protocol of Randomized Controlled Trials
Abstract Background Abdominal cancer surgeries have a high incidence of postoperative complications. One strategy to prevent postoperative complications is preoperative exercise training. There are no systematic reviews that have compared the effects of preoperative exercise training programs of different length, frequency and duration on pre and postoperative clinical outcomes as well as on length of hospital stay (LOS) and in-hospital and late mortality in people with abdominal cancer. Methods Searches for randomised controlled trials (RCTs) of preoperative exercise training for people undergoing major surgery for abdominal cancer will be conducted in Pubmed, EMBASE, PEDro (Physiotherapy Evidence Database) and the Cochrane Library. There will be no restrictions on the language or date of publication in the search. The primary outcomes of the systematic review will be incidence of postoperative pulmonary complications as well as post-intervention and postoperative exercise capacity. The risk of bias of included RCTs will be assessed using the PEDro scale. The quality of evidence will be rated using the GRADE system (Grading of Recommendations Assessment, Development and Evaluation). Subgroup analyzes will be conducted based on: intervention performed with or without supervision; types of exercises; and frequency and duration of the intervention. Discussion Our hypothesis is that preoperative exercise training will reduce the incidence of postoperative pulmonary complications in people undergoing major surgery for abdominal cancer by improving their preoperative exercise capacity. We will also explore the effects of the program on LOS and mortality. Systematic review registration: This systematic review protocol was registered with PROSPERO (Prospective International Register of Systematic Reviews) (number CRD42020199765).