A prospective randomised controlled trial to investigate the effects of a pre-operative prehabilitation protocol on clinical outcomes of gastric cancer patients with metabolic syndrome who undergo laparoscopic radical gastrectomies and to determine the underlying mechanisms.

To investigate the effects of a pre-operative prehabilitation protocol on clinical outcomes of gastric cancer patients with metabolic syndrome who undergo laparoscopic radical gastrectomies and to determine the underlying mechanisms.

Inclusion Criteria:

• histologically-proven pre-operative stage I-III gastric cancer
• Combined with metabolic syndrome
• Age limits from 18 to 80 years old
• Classified into American Society of Anesthesiology (ASA) II or III surgical risk
• no history of abdominal surgery on organs located at the abdominal supramesocolic level

Exclusion Criteria:

• Combined with severe cardiac or pulmonary disease or other organ dysfunction
• ASA IV
• The history of abdominal surgery
• Conversion to open surgery
• The presence of gastrointestinal obstruction, perforation or necrosis;
• Declined to participate in this study