ABSTRACT
BACKGROUND: Radical surgery is the mainstream treatment for patients presenting with advanced primary or recurrent gastrointestinal cancers; however, the rate of postoperative complications is exceptionally high. The current evidence suggests that improving patients' fitness during the preoperative period may enhance postoperative recovery. Thus, the primary aim of this study is to establish the effectiveness of prehabilitation with a progressive, individualised, preoperative exercise and education program compared to usual care alone in reducing the proportion of patients with postoperative in-hospital complications. The secondary aims are to investigate the effectiveness of the preoperative intervention on reducing the length of intensive care unit and hospital stay, improving quality of life and morbidity, and reducing costs. METHODS: This is a multi-centre, assessor-blinded, pragmatic, comparative, randomised controlled trial. A total of 172 patients undergoing pelvic exenteration, cytoreductive surgery, oesophagectomy, hepatectomy, gastrectomy or pancreatectomy will be recruited. Participants will be randomly allocated to prehabilitation with a preoperative exercise and education program (intervention group), delivered over 4 to 8 weeks before surgery by community physiotherapists/exercise physiologists, or usual care alone (control group). The intervention will comprise 12 to 24 individualised, progressive exercise sessions (including aerobic/anaerobic, resistance, and respiratory exercises), recommendations of home exercises (16 to 32 sessions), and daily incidental physical activity advice. Outcome measures will be collected at baseline, the week prior to surgery, during the hospital stay, and on the day of discharge from hospital, and 1 month and 1 months postoperatively. The primary outcome will be the development of in-hospital complications. Secondary outcomes include the length of intensive care unit and hospital stay, quality of life, postoperative morbidity and costs. DISCUSSION: The successful completion of this trial will provide robust and high-quality evidence on the efficacy of a preoperative community- and home-based exercise and education intervention on important postoperative outcomes of patients undergoing major gastrointestinal cancer surgery. TRIAL REGISTRATION: This trial was registered prospectively with the Australian New Zealand Clinical Trials Registry ( ACTRN12621000617864 ) on 24th May 2021.
Subject(s)
Abdominal Neoplasms , Preoperative Exercise , Abdominal Neoplasms/complications , Australia , Exercise Therapy/methods , Humans , Multicenter Studies as Topic , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Preoperative Care/methods , Quality of Life , Randomized Controlled Trials as TopicABSTRACT
Sewerage systems are paramount underground infrastructure assets for any nation. In most cities, they are old and have been exposed to significant microbial induced corrosion. It is a serious global problem as they pose threats to public health and economic repercussions to water utilities. For managing sewer assets efficaciously, it is vital to predict the rate of corrosion. Predictive models of sewer corrosion incorporate concrete surface temperature measurements as an observation. However, currently, it has not been fully utilized due to unavailability of a proven sensor. This study reports the feasibility of infrared radiometer for measuring the surface temperature dynamics in the aggressive sewer conditions. The infrared sensor was comprehensively evaluated in the laboratory at different environmental conditions. Then, the sensor suite was deployed in a Sydney based sewer for three months to perform continuous measurements of surface temperature variations. The field study revealed the suitability of the developed sensor suite for non-contact surface temperature measurements in hostile sewer conditions. Further, the accuracy of the sensor measurements was improved by calibrating the sensor with emissivity coefficient of the sewer concrete. Overall, this study will ameliorate the present sewer corrosion monitoring capabilities by providing new data to models predicting sewer corrosion.
