DiSCO: Defining Standards in Colorectal Optimisation


Miss Susan Moug, Consultant Surgeon and Honorary Clinical Associate Professor, University of Glasgow, Scotland.

Thousands of patients per year in the UK need to have an operation due to bowel disease. It can take time to recover from an operation, especially if the patient is not physically fit or prepared beforehand. This means that people may stay in hospital for longer than they would like, as well as take longer to get back to doing everyday activities. Over the last five years researchers and Doctors have been studying whether or not getting patients physically and psychologically ready for their operation, called pre-habilitation or prehab, is possible.

These studies have shown that prehab is safe in many different patients, including the elderly and those with stomas and those who are less active. Prehab potentially leads to better outcomes for patients with fewer complications, a shorter stay in hospital, and returning to their day-to-day activities more quickly. What has not yet been looked at are what outcomes are important to patients when assessing the effectiveness of any pre-habilitation offered before bowel surgery. This study aims to determine standards that can be used in future prehab researches that are relevant to patients.

From a long list of studies, patients, and healthcare professionals will vote on what they think is important to have in prehab. There will be a number of online voting rounds, which will highlight any differences in opinion, and allow a short list of prehab standards to be drawn up. Patients and healthcare professionals will then discuss these at a face-to-face meeting (Edinburgh ACPGBI 2020), where a final vote will be made on what outcomes to include.

This study is novel as nobody has tried to define standards for prehab before, nor has anyone asked the opinions of healthcare professionals, exercise specialists and patients. This work will define standards that should allow implementation of prehab in colorectal surgery, leading to better outcomes for patients.

Prehab is very topical at the moment, but much work needs to be done to ensure that bowel patients get individualised prehab that works for them. IA represents a group of bowel patients and the outputs from this work will not only potentially help IA patients, but will advertise the work of IA to a large audience.

Duration of project

18 months


£10,920 funded by IA