ResearchOriginal ResearchPrehabilitation with Whey Protein Supplementation on Perioperative Functional Exercise Capacity in Patients Undergoing Colorectal Resection for Cancer: A Pilot Double-Blinded Randomized Placebo-Controlled Trial
Section snippets
Patients
The study was approved by the McGill University Health Centre Research Ethics Board, Montreal, Quebec, Canada, and the protocol was registered at http://clinicaltrials.gov (NCT 01727570). Consecutive adult patients scheduled for elective resection of nonmetastatic colorectal cancer were approached at their first appointment with their surgeon at a single university-affiliated tertiary center located in Montreal, and written informed consent was obtained in eligible patients. Patients with poor
Patients
A total of 68 patients were approached for consent, of which 48 patients were randomized (Figure) between September 2012 and October 2013. Four patients dropped out (ie, did not complete any follow-up assessment), and one patient underwent emergency surgery after randomization. Therefore, a total of 43 patients were analyzed (22 in the whey protein group and 21 in the placebo group). Patient clinical characteristics (Table 1) and baseline measures (Table 2) were similar between groups. The
Discussion
The results of this pilot study provide insight into the role of nutrition prehabilitation on functional capacity. Preoperative nutrition counseling with whey protein supplementation produced a clinically meaningful increase >20 m in functional walking capacity before surgery. Although the results are promising and warrant further larger-scale investigation, practical clinical inferences cannot be made because of the small sample size, variability, and pilot nature of the study.
Gastrointestinal
Conclusion
This pilot study suggested that nutrition played an integral role in preparing patients for surgery. The results are encouraging and justify larger-scale trials to define the specific role of nutritional prehabilitation on functional recovery after surgery.
Acknowledgements
The authors thank the personnel of the McGill University Health Center (Montreal, Canada) colorectal clinic for helping with the recruitment, Mary Guay for her support with the measurements, Immunotec Inc (Quebec, Canada) for graciously supplying the whey protein powder, and Natalie MacLellan, MAdEd, of Best Foot Forward for professional editing.
C. Gillis is a registered dietitian, Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada.
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Cited by (0)
C. Gillis is a registered dietitian, Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada.
R. Awasthi is a kinesiologist, Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada.
F. Carli is an anesthesiologist, Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada.
S.-E. Loiselle is a professional dietitian, School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada.
L. Wykes is director and professor, School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada.
J. F. Fiore, Jr, is a physiotherapist, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
A. S. Liberman is a surgeon, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
B. Stein is a surgeon, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
P. Charlebois is a surgeon, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This research was funded by Canadian Foundation for Dietetic Research (CFDR).
ClinicalTrials.gov registration: NCT 01727570.
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Certified in Canada.
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Professional dietitian certified in Quebec (equivalent to RD).