UM PROGRAMA DE PRÉ-HABILITAÇÃO DOMICILIAR, APLICADO ATRAVÉS DE UMA PLATAFORMA BASEADA NA INTERNET, EM DOENTES COM ADENOCARCINOMA LOCALMENTE AVANÇADO DA JUNÇÃO GASTROESOFÁGICA E ESTÔMAGO, ELEGÍVEIS PARA QUIMIOTERAPIA PERIOPERATÓRIA: PROTOCOLO PARA ESTUDO D

  • Daniel Moreira-Gonçalves Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal http://orcid.org/0000-0002-7404-7405
  • Antero do Vale Fernandes Intensive Care Service of Hospital Garcia de Orta, E.P.E, Almada, Portugal http://orcid.org/0000-0002-6986-083X
  • Clara Daher Mota Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal; Experimental Pathology and Therapeutics Group, Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal
  • João Antunes Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal; Experimental Pathology and Therapeutics Group, Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal
  • Carina Canappele Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
  • Pedro Martins Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal http://orcid.org/0000-0002-1828-078X
  • Fátima Santos Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal http://orcid.org/0000-0003-3796-2054
  • Sónia Cabral Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal
  • Carolina Castro Experimental Pathology and Therapeutics Group, Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal
  • Cristina Mendes Santos Experimental Pathology and Therapeutics Group, Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal
  • Susana Almeida Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal
  • Jéssica Rodrigues Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal
  • Otília Romano Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal
  • Ana Sofia Fonseca Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal
  • Patrícia Lages General Surgery Service, Hospital Garcia de Orta, E.P.E, Almada, Portugal http://orcid.org/0000-0003-3868-5685
  • Paulo Matos Costa General Surgery Service, Hospital Garcia de Orta, E.P.E, Almada, Portugal http://orcid.org/0000-0002-7550-8285
  • Lúcio Lara Santos Experimental Pathology and Therapeutics Group, Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal; Portuguese Oncology Institute of Porto FG, EPE (IPO-Porto), Porto, Portugal http://orcid.org/0000-0002-0521-5655

Resumo




Introdução: A pré-habilitação corresponde a uma intervenção multimodal, implementada no período pré-operatório, com o objetivo de aumentar a reserva funcional pré-operatória, acelerar a recuperação funcional pós-operatória e reduzir da incidência de complicações. A maioria dos programas de pré-habitabilitação é desenvolvida sob supervisão médica em ambulatório, o que pode ser um obstáculo para aqueles doentes com restrições geográficas e / ou de transporte. Programas domiciliares, com o apoio a recursos de telemedicina, poderão ser uma estratégica conveniente de superar essas barreiras.


Métodos: Doentes com adenocarcinoma gástrico ou junção gastroesofágica localmente avançado, potencialmente ressecável, em quimioterapia perioperatória com regime FLOT serão recrutados no IPO-Porto e no Hospital Garcia de Orta. Os participantes serão convidados a realizar um programa de pré-habilitação com exercício físico (PREHAB) complementar aos cuidados habituais (otimização médica, atendimento nutricional e psicológico). A intervenção com exercício físico incluirá treino combinado (exercício aeróbio e resistido) e treino dos músculos inspiratórios. Uma plataforma digital (iTherapy), acessível via computador ou dispositivos móveis, será utilizada para implementar e monitorizar a intervenção. O objetivo principal deste estudo é testar a aceitabilidade, viabilidade e segurança da intervenção. Como objetivos secundários, pretendemos avaliar o impacto da pré-habilitação domiciliar na capacidade funcional, estado de fragilidade, qualidade de vida, incapacidade, complicações pós-operatórias e mortalidade, tempo de hospitalização, necessidade de UCI, readmissão hospitalar e local de alta.


Conclusão: Este estudo servirá de base para um futuro ensaio clínico randomizado para avaliar o papel da pré-habilitação na redução da morbimortalidade pós-operatória nesta população.




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Publicado
2022-02-03
Como Citar
MOREIRA-GONÇALVES, Daniel et al. UM PROGRAMA DE PRÉ-HABILITAÇÃO DOMICILIAR, APLICADO ATRAVÉS DE UMA PLATAFORMA BASEADA NA INTERNET, EM DOENTES COM ADENOCARCINOMA LOCALMENTE AVANÇADO DA JUNÇÃO GASTROESOFÁGICA E ESTÔMAGO, ELEGÍVEIS PARA QUIMIOTERAPIA PERIOPERATÓRIA: PROTOCOLO PARA ESTUDO D. Revista Portuguesa de Cirurgia, [S.l.], n. 51, p. 125-136, feb. 2022. ISSN 2183-1165. Disponível em: <https://revista.spcir.com/index.php/spcir/article/view/938>. Acesso em: 26 june 2022. doi: https://doi.org/10.34635/rpc.938.
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