Hepatic steatosis in patients undergoing resection of colorectal liver metastases: A target for prehabilitation? A narrative review

Doherty, Daniel T.; Coe, P O; Rimmer, Lara; Lapsia, Snehal; Krige, Anton; Subar, Daren

doi:10.1016/j.suronc.2019.07.007

Cited by 9 publications

(3 citation statements)

References 90 publications

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“…Both reviews underlined that several included studies were underpowered and that standardized outcome measures should be defined in future analyses. A narrative review on prehabilitation for patients with steatosis suggested that the 4–6-week period before the operation could be used for prehabilitation including dietary intervention to decrease intrahepatic fat and improve postoperative outcomes [ 16 ]. Another further narrative review on older patients recommended a focus on high-risk patients who could benefit from prehabilitation [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022

et al. 2022

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Background Enhanced Recovery After Surgery (ERAS) has been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016. The aim of the present article was to update the ERAS guidelines in liver surgery using a modified Delphi method based on a systematic review of the literature. Methods A systematic literature review was performed using MEDLINE/PubMed, Embase, and the Cochrane Library. A modified Delphi method including 15 international experts was used. Consensus was judged to be reached when >80% of the experts agreed on the recommended items. Recommendations were based on the Grading of Recommendations, Assessment, Development and Evaluations system. Results A total of 7541 manuscripts were screened, and 240 articles were finally included. Twenty-five recommendation items were elaborated. All of them obtained consensus (>80% agreement) after 3 Delphi rounds. Nine items (36%) had a high level of evidence and 16 (64%) a strong recommendation grade. Compared to the first ERAS guidelines published, 3 novel items were introduced: prehabilitation in high-risk patients, preoperative biliary drainage in cholestatic liver, and preoperative smoking and alcohol cessation at least 4 weeks before hepatectomy. Conclusions These guidelines based on the best available evidence allow standardization of the perioperative management of patients undergoing liver surgery. Specific studies on hepatectomy in cirrhotic patients following an ERAS program are still needed.

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Section: Resultsmentioning

confidence: 99%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022

et al. 2022

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“…Elevated intra-hepatic fat (IHF) is an independent risk factor for post-operative morbidity following hepatic resection of CRLM [46]. Hepatic steatosis (HS) alters the component diversity of liver microenvironment, and it may affect metastases foci formation and chemotherapeutic response in patients with CRLM [47][48][49].…”

Section: Intratumoural Fat Depositionmentioning

confidence: 99%

Assessment of the response to systemic treatment of colorectal liver metastases on cross-sectional imaging – a systematic review

Morawska,

Cieszanowski

2023

Pol J Radiol

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Colorectal cancer (CRC) is one of the most common malignancies in the world. Nowadays many treatments are available to help control CRC, including surgery, radiation therapy, interventional radiology, and drug treatments. A multidisciplinary approach and the role of radiologists is needed to assist the surgeon in the management thanks to emerging technology and strategies. The Response Evaluation Criteria in Solid Tumours (RECIST) has been created to objectify and standardize cancer response assessment. Thus, in this article specific presumptions and practical aspects of evaluating responses according to the RECIST 1.1 are discussed. Furthermore, examples of possible response to systemic treatment of colorectal liver metastases (CRLM), including tumour necrosis, apparent diffusion coefficient (ADC) values, tumour calcification, tumour fibrosis and intratumoural fat deposition observed on cross-sectional imaging, are described. Disappearing liver metastases (DLM) presents a therapeutic dilemma. The optimal management of DLM remains controversial due to the uncertainty of residual microscopic disease and effective long-term outcomes. The article provides an overview of the CRLM phenomenon and current possible assessment methods of the response to systemic treatment.

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“…To obtain initial anthropometric and to conduct subjective global assessment: this is especially important in context of liver resection as malnutrition is very common in patients with cirrhosis [39] and to add to this, precise evaluation of their nutrition status is difficult with the presence of ascites and edema [40] . A review by Doherty et al [41] identifies intra hepatic fat as an independent risk factor for post-operative morbidity following hepatic resection. Dietary interventions such as calorie restriction, carbohydrate restriction or a Mediterranean diet have shown reductions in pre-operative intra hepatic fat by up to 55% [40] .…”

Section: Dieticianmentioning

confidence: 99%

Prehabilitation in elderly patients scheduled for liver resection and protocol for Recovery Of Surgery in Elderly

Mohan¹,

Huey²,

Junnarkar³

et al. 2020

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Ageing population of first world economies pose unique challenges to surgical community. Enhanced recovery after surgery protocols and pathways do not attempt to optimize or enhance physical function of patients by customized program of physical activity. Increasingly, prehabilitation programs (PP) have gained momentum in orthopaedics, urology, colorectal surgery and hepatopancreaticobiliary surgery. Current evidence of PP in various elective surgical procedures have shown improved outcomes with minimal to none drawback or harm. There is emerging evidence of role of PP in elective liver resection. The aim of this paper is to review the basis of PP and share local multidisciplinary team protocol specifically customized to frail and elderly population-Recovery Of Surgery in Elderly.

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Hepatic steatosis in patients undergoing resection of colorectal liver metastases: A target for prehabilitation? A narrative review

Cited by 9 publications

References 90 publications

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022

Assessment of the response to systemic treatment of colorectal liver metastases on cross-sectional imaging – a systematic review

Prehabilitation in elderly patients scheduled for liver resection and protocol for Recovery Of Surgery in Elderly

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