Enchanted recovery. Preoperative preparation and prehabilitation.

Abstract

Fast Track surgery (FTS), as well as ERAS (enhanced recovery after surgery/rapid recovery after surgery programs) or ERP (enhanced recovery program, in russian) is a multimodal and multidisciplinary treatment strategy designed to reduce the duration of disability and improve the quality of medical care. This program includes preparation at the preoperative stage, the use of minimally invasive techniques for performing surgical intervention and active management of the postoperative period to reduce the duration of inpatient treatment, rehabilitation time and the fastest possible return of patients to normal life. In the context of this review, the features of preparation and prehabilitation at the preoperative stage of the enhanced recovery program are considered. The main elements of the strategy are reviewed: correction of eating disorders, carbohydrate loading, preoperative education and problems of multidisciplinary interaction, sarcopenia, lifestyle changes, pharmacogenomics, correction of anemia and preoperative bowels preparation. Prehabilitation and preoperative preparation together help make the patient for surgery and subsequent recovery. The main elements of training are patient and staff training, multidisciplinary interaction, correction of concomitant somatic disorders and diseases, nutrition optimization and lifestyle changes.