Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery

Minnella, Enrico Maria; Awasthi, Rashami; Loiselle, Sarah-Ève; Agnihotram, Ramanakumar V.; Ferri, Lorenzo; Carli, Francesco

doi:10.1001/jamasurg.2018.1645

Cited by 305 publications

(322 citation statements)

References 65 publications

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“…However, only 42% of patients could tolerate the 8‐week program and it was concluded that careful patient selection was necessary to achieve optimum results. Findings from Minnella et al () also provide support for benefits from pre‐operative rehabilitation (prehabilitation), although participation may challenge some patient groups.…”

Section: Discussionmentioning

confidence: 94%

“…Derogar et al (2012) encouraged rehabilitation for patients who experience significant complications with evidence of a positive effect on quality of life and psychological and physical morbidity (Chasen & Bhargava, 2010). Inoue et al (2012) describe significantly fewer incidences of post-operative respiratory complications in patients undergoing 7 or more days of pre-operative respiratory rehabilitation compared to those who did not and Minnella et al (2018) demonstrated improvement in pre-operative functional capacity through prehabilitation comprising of a structured exercise and nutritional program. Enhanced recovery after surgery (ERAS) programs have also been adopted in many centres as benefit has been derived by means of reduced length of stay and complications (Marker, Karthikesalingam, & Low, 2015).…”

Section: Introductionmentioning

confidence: 99%

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The role of rehabilitation in patients undergoing oesophagectomy for cancer and pre-malignant disease: A qualitative exploration of the views of patients, carers and healthcare providers

et al. 2019

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Objective Oesophagectomy for cancer is associated with significant morbidity and mortality, and reduced quality of life. Structured rehabilitation potentially offers improved physical and psychological outcomes. We aimed to explore patient, carer and healthcare provider attitudes and preferences towards the role of rehabilitation. Methods We interviewed 15 patients who had undergone an oesophagectomy, 10 carers and 13 healthcare providers about perceived impacts of treatment; preferred components of a rehabilitation program; barriers/enablers of support provision; and participation in rehabilitation programs. Data were analysed using framework analysis. Results The overarching theme was “Getting back to normal.” Diagnosis of disease signified a disruption to the normal trajectory of patients’ lives and the post‐treatment period was characterised as striving to return to normal. Patients and carers focused on rehabilitation needs post‐treatment including dietary support, physiotherapy and healthcare provider support. Healthcare providers described rehabilitation as potentially beneficial from the pre‐treatment phase and, along with carers, highlighted the importance of psychological support. Barriers included access to services, cost of service provision and appointment burden. Conclusion A need for rehabilitation services was identified by healthcare providers from the point of diagnosis, rather than only after surgery. Implications include improved service provision by healthcare institutions for patients undergoing oesophagectomy.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

The role of rehabilitation in patients undergoing oesophagectomy for cancer and pre-malignant disease: A qualitative exploration of the views of patients, carers and healthcare providers

et al. 2019

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“…To date, few studies have examined using pre-operative exercise whilst patients are receiving NAC. 12,[15][16][17] The aims of this study are:…”

Section: Introductionmentioning

confidence: 99%

Adherence to Pre-operative Exercise and the Response to Prehabilitation in Oesophageal Cancer Patients

Halliday

Doganay

Wynter-Blyth

et al. 2021

Journal of Gastrointestinal Surgery

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Background Prehabilitation is thought to reduce post-operative respiratory complications by optimising fitness before surgery. This prospective, single-centre study aimed to establish the effect of pre-operative exercise on cardiorespiratory fitness in oesophageal cancer patients and characterise the effect of adherence and weekly physical activity on response to prehabilitation. Methods Patients received a personalised, home-based pre-operative exercise programme and self-reported their adherence each week. Cardiorespiratory fitness (pVO 2 max and O 2 pulse) was assessed at diagnosis, following completion of neoadjuvant chemotherapy (NAC) and immediately before surgery. Study outcomes included changes in fitness and post-operative pneumonia. Results Sixty-seven patients with oesophageal cancer underwent prehabilitation followed by surgery between January 2016 and December 2018. Fitness was preserved during NAC and then increased prior to surgery (pV0 2 max Δ = +2.6 ml min −1 , 95% CI 1.2-4.0 p = 0.001; O 2 pulse Δ = +1.4 ml beat −1 95% CI 0.5-2.3 p = 0.001). Patients with higher baseline fitness completed more physical activity. Regression analyses found adherence was associated with improvement in fitness immediately before surgery (p = 0.048), and the amount of physical activity completed was associated with the risk of post-operative pneumonia (p = 0.035). Conclusion Pre-operative exercise can maintain cardiorespiratory fitness during NAC and facilitate an increase in fitness before surgery. Greater exercise volumes were associated with a lower risk of post-operative pneumonia, highlighting the importance progressing exercise programmes throughout prehabilitation. Patients with high baseline fitness completed more physical activity and may require less supervision to reach their exercise goals. Further research is needed to explore stratified approaches to prehabilitation.

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Section: Discussionmentioning

confidence: 99%

“…In a recent study by Minnella et al (2018) 31 , the effects of a prehabilitation intervention on functional capacity were investigated in patients with esophageal cancer undergoing surgery. A significant improvement in functional capacity was found in patients who received a prehabilitation intervention, although no differences were found with respect to the incidence of postoperative complications, length of hospital stay and readmission rates [31]. Hulzebos et al (2006) [30] demonstrated that preoperative inspiratory muscle training decreased the incidence of postoperative pulmonary complications and length of hospital stay compared to usual care in patients undergoing coronary artery bypass graft (CABG).…”

Section: Discussionmentioning

confidence: 99%

The pre- and postoperative course of functional status in patients undergoing esophageal cancer surgery

Egmond

Schaaf

Klinkenbijl

et al. 2020

European Journal of Surgical Oncology

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Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery

Abstract: ClinicalTrials.gov Identifier: NCT01666158.

Cited by 305 publications

References 65 publications

The role of rehabilitation in patients undergoing oesophagectomy for cancer and pre-malignant disease: A qualitative exploration of the views of patients, carers and healthcare providers

The role of rehabilitation in patients undergoing oesophagectomy for cancer and pre-malignant disease: A qualitative exploration of the views of patients, carers and healthcare providers

Adherence to Pre-operative Exercise and the Response to Prehabilitation in Oesophageal Cancer Patients

The pre- and postoperative course of functional status in patients undergoing esophageal cancer surgery

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