Preop CPET Testing and Exercise Training in Colorectal Patients

Colorectal Surgery Preoperative Exercise Training is a study being run by the colorectal surgery team at the Norfolk and Norwich University Hospital and the University of East Anglia to look at the role of exercise before surgery to improve recovery following an operation.
Having an operation to remove part of the bowel puts physical stress on the body. We know that training can help the body cope with physical stress in the same way that an athlete trains before a competition. We hypothesise that the body may recover more quickly if it is trained prior to an operation with regular and simple exercises.
Cardiopulmonary exercise testing (CPET) is used to evaluate the function of the lungs, heart and muscles at rest and during exercise. CPET testing is often done as part of standard pre-operative assessment in many hospitals for patients before undergoing major surgery. Some studies have demonstrated that CPET can be used to predict outcomes following surgery (such as time taken till discharge, complication rates).
The study consists of two parts:
Study 1) CPET variables to predict outcomes in surgery - patients will undergo a CPET test to determine baseline fitness. Blood tests will be taken around the time of surgery to examine whether biochemical markers in the bloodstream (when used in combination with results from the CPET test) can predict outcomes and recovery following colorectal surgery. Patients will then be monitored to assess their speed of recovery and rate of complications following surgery.
This will enable us to determine which CPET variables or combination of variables are most useful in the prediction of post-operative complications following colorectal surgery.
2) The second study will consist of an exercise intervention involving several sessions of supervised exercise in a laboratory. Before and at the end the exercise training regime, CPET measurements will be taken to see if fitness has improved with exercise.
This part of of the study is to determine if it is feasible to implement a structured, supervised exercise programme for patients awaiting elective colorectal cancer surgery. The results of this study will be used to inform a larger randomised controlled trial to examine the influence of exercise on CPET variables and postoperative outcomes.

结直肠外科术前运动训练（Colorectal Surgery Preoperative Exercise Training）是由诺福克和诺里奇大学医院结直肠外科团队与东安格利亚大学联合开展的一项研究，旨在探讨术前运动在改善术后康复中的作用。
切除部分肠道的手术会对机体造成生理应激。正如运动员在赛前进行训练以应对竞技压力，术前运动同样可帮助机体适应生理应激。本研究提出假说：通过规律且简便的术前运动对机体进行预训练，可加快术后康复速度。
心肺运动试验（Cardiopulmonary Exercise Testing, CPET）用于评估机体静息及运动状态下的肺、心脏与肌肉功能。目前，许多医院在为大型手术患者开展标准术前评估时，常将CPET纳入其中。已有研究证实，CPET可用于预测手术结局，如术后住院时长、并发症发生率等。
本研究包含两个子课题：
子课题1：基于CPET参数预测手术结局——入组患者将接受CPET检测以确定其基础健康状态。本研究将在手术围术期采集血液样本，探究血液生化标志物与CPET检测结果联合应用时，是否可预测结直肠手术患者的术后结局与康复情况。后续将对患者进行随访，评估其术后康复速度与并发症发生率。本环节旨在明确哪些CPET参数或参数组合，对预测结直肠手术后并发症最为有效。
子课题2：运动干预——在实验室环境下开展多节次督导式运动干预。在运动训练方案实施前后，将分别进行CPET检测，以评估运动干预对患者健康状态的改善效果。本环节旨在探讨为择期结直肠癌手术患者实施结构化督导运动方案的可行性。本研究结果将为后续开展更大规模的随机对照试验提供依据，以探究运动对CPET参数及术后结局的影响。