Pilot and feasibility studies
Preoperative inspiratory muscle training for patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a randomized feasibility study
By Sand O, Arakelian E, Semenas E and 3 others.
Abstract
Background
Patients undergoing surgery due to peritoneal metastases (PM) are at high risk of postoperative pulmonary complications (PPCs). While several studies have provided promising results regarding the positive effects of preoperative inspiratory muscle training (IMT) regarding length of hospital stay and PPCs after other types of major abdominal surgery, its feasibility in the preoperative management of patients with PM is still unclear. The aim of the study was to evaluate the feasibility of preoperative IMT for patients scheduled for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
Methods
A single-blinded randomized controlled feasibility study was conducted in Uppsala, Sweden, between 2016 and 2020. Inclusion criteria were age ≥ 18 years, surgery scheduled ≥ 2 weeks after inclusion, and proficiency in Swedish. Patients were randomized 1:1 to either IMT or positive expiratory pressure (PEP). Feasibility was evaluated using two domains: process feasibility (recruitment, intervention adherence, and patient acceptability) and scientific feasibility (ability to perform pre- and postoperative respiratory muscle and lung function assessments, reproducibility of assessments, and adverse events). Preliminary treatment effects and incidence of postoperative pulmonary complications (PPCs) were also evaluated.