Patients’ perspectives of prehabilitation as an extension of Enhanced Recovery After Surgery protocols

Gillis, Chelsia; Gill, Marlyn; Gramlich, Leah; Culos-Reed, S. Nicole; Nelson, Gregg; Ljungqvist, Olle; Carli, Franco; Fenton, Tanis R.

doi:10.1503/cjs.014420

Cited by 33 publications

(34 citation statements)

References 29 publications

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“…Most patients experience psychological stress before surgery. 148 Some observational evidence suggests that severe psychological distress, as seen in anxiety or depression, can produce a dysregulated hypothalamicepituitaryeadrenal axis response, initiating a stress response before surgery and contributing to postoperative disruptions in immune function. 149 Indeed, preoperative anxiety, depression, fear, and psychological stress are associated with worse surgical outcomes, including length of hospital stay.…”

Section: Psychosocial Statusmentioning

confidence: 99%

Prehabilitation, enhanced recovery after surgery, or both? A narrative review

Gillis

Ljungqvist

Carli

2022

British Journal of Anaesthesia

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Section: Psychosocial Statusmentioning

confidence: 99%

Prehabilitation, enhanced recovery after surgery, or both? A narrative review

Gillis

Ljungqvist

Carli

2022

British Journal of Anaesthesia

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“…As a continuum of the ERAS program prehabilitation should be integrated in the perioperative pathway. 49,50 Several weeks may elapse between the decision to proceed with surgery and the surgery itself. This also represents a teachable moment and is the ideal point in time in the perioperative trajectory to be physically active.…”

Section: Prehabilitation: Practical Aspects Of Clinical Care For Whom...mentioning

confidence: 99%

“…How? As a continuum of the ERAS program prehabilitation should be integrated in the perioperative pathway 49,50 . Several weeks may elapse between the decision to proceed with surgery and the surgery itself.…”

Section: Prehabilitation: Practical Aspects Of Clinical Care For Whom...mentioning

confidence: 99%

Strategies for optimal perioperative outcomes in gastric cancer

Engel

Goh

Minnella

et al. 2022

Journal of Surgical Oncology

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Cancer and surgery represent a major stress on the human body. Any condition that prevents patients from tolerating the physiological stress is a risk factor for poor outcome. There is a need to identify these impairments early in the process with a simple screening, followed by assessments that provide a holistic picture of the patient. The proposed path of multimodal prehabilitation acts synergistically with enhanced recovery after surgery care to achieve optimal patient outcomes.

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“…I just…I had to come, I had to get it done." [97]. Compounded episodes of acute catabolism are believed to contribute to the development of sarcopenia (depleted muscle mass and function), frailty (vulnerability to stressors), and eventually a loss of independence [7].…”

Section: Prehabilitation Represents An Opportunity To Mitigate Sarcopenia and Frailtymentioning

confidence: 99%

Protein for the Pre-Surgical Cancer Patient: a Narrative Review

Gillis

Phillips

2021

Curr Anesthesiol Rep

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Purpose of Review Prehabilitation prepares patients to withstand the rigors of surgery; however, there is little consensus on nutritional prehabilitative support for surgical patients. In this narrative review, we offer our perspectives on the role of protein in surgical prehabilitation. Recent Findings While the exact dietary protein requirements of pre-surgical patients are unknown, protein is an important piece of any nutritional care plan. Body protein, in particular skeletal muscle, is catabolized to support surgery-related systemic responses such as inflammation and wound healing. Older adults and patients with cancer, who may be sarcopenic, undernourished, or cachectic, often experience perturbations in protein metabolism that deplete skeletal muscle tissue prior to surgery. Reduced body protein combined with surgery-induced stress can result in a concomitant loss of physiologic function. Summary Multi-modal prehabilitation that includes nutrition and exercise can augment patients' body protein reserve before surgery and mitigate losses post-surgery to improve functional outcomes.

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Patients’ perspectives of prehabilitation as an extension of Enhanced Recovery After Surgery protocols

Cited by 33 publications

References 29 publications

Prehabilitation, enhanced recovery after surgery, or both? A narrative review

Prehabilitation, enhanced recovery after surgery, or both? A narrative review

Strategies for optimal perioperative outcomes in gastric cancer

Protein for the Pre-Surgical Cancer Patient: a Narrative Review

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