Feasibility of a Home-Based Multimodal Prehabilitation Program for Patients Undergoing Esophagectomy: A Prospective Feasibility Study in a Portuguese Tertiary Hospital
DOI:
https://doi.org/10.34635/rpc.1200Keywords:
Enhanced Recovery After Surgery, Esophageal Neoplasms/surgery, Esophagectomy, Nutritional Status, Nutrition Therapy, Postoperative Complications/prevention & control, Preoperative Care, Preoperative ExerciseAbstract
Introduction: Esophageal cancer is a lethal malignancy and can be treated with neoadjuvant therapy and esophagectomy, a complex procedure associated with significant morbidity. Prehabilitation is increasingly recognized as an important part of perioperative optimization of patients' physical and mental status before surgery and can potentially improve postoperative outcomes. The feasibility of prehabilitation before surgery within the Portuguese public healthcare system remains unclear. This study aims to evaluate the feasibility, acceptability, and safety of a home-based multimodal prehabilitation program for esophageal cancer patients in a tertiary hospital.
Methods: This prospective, interventional feasibility study consisted of a home-based program combining aerobic and resistance training with nutritional support. Feasibility outcomes included recruitment, completion, dropout and adherence rates. Acceptability among patients and healthcare professionals was assessed using a Likert scale. Safety was evaluated by recording adverse events during the intervention period.
Results: Between January and May 2026, eight patients were screened, seven were enrolled, four completed the program (recruitment rate: 100%; completion rate: 57.1%) and three patients were discontinued due to disease progression. Adherence to the exercise program was 64.2%, and participation in weekly monitoring calls reached 100%. No exercise-related adverse events occurred. The intervention was well accepted by patients and healthcare professionals.
Conclusion: This home-based program proved to be feasible and safe, showing high patient engagement and retention. The findings also highlight the importance of organizational support and workflow adjustments. Nevertheless, the small number of patients screened over three months and the fact that only four completed the full program indicate that recruitment and retention will require careful attention before a larger trial.
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