The experience of prehospital pharmacological coach in colon cancer patients

Abstract

Objectives: Bladder cancer and its surgical treatment by radical cystectomy has a high morbidity and mortality. The goal of our prehabilitation therapy is to achieve optimum physical and mental conditions before starting the treatment, enhancing the functional capacity and, therefore, decreasing postoperative morbidity and accelerating post-surgical recovery. Methods: Patients were included in a prospective study and after informed consent were put into one of the two groups designed: G1: Prehabilitation Group; G2: Non Prehabilitation Group. All patients were managed with an enhanced recovery programme. Functional capacity was evaluated by the six minute walking test (SMWT) in three different perioperative time points: CFO: baseline; CF1: one week before surgery; CF2: one month after discharge. The length of stay in the Intensive Care Unit (ICU) and the hospital stay were analysed, as well as postoperative complications according to the Clavien scale till 30 days after surgery. A p value <0,05 was considered statistically significant. Results: The sample included 30 patients (G1: 15; G2: 15). No group differences in anthropometric variables and anesthetic risk were found. In G1 statistically significant differences were found, with the distance walked in CF1 (554.3 ± 74.8) in regard to CF0 (519.1 ± 75.0) and CF2 (560.0 ± 34.6) in regard to CF0. Statistically significant differences were also found regarding days of ICU stay (G1: 1.6 ± 1.1; G2: 2.6 ± 2.1) and days of hospital stay (G1:14.5 ± 9.7; G2:18.1 ± 12.6). Postoperative complications according to the Clavien scale found statistically significant differences (G1: 1.7 ± 1.0; G2: 2.7 ± 1.2). Conclusion: There was an improvement in the distance walked by the patients following prehabilitation therapy, being maintained even one month after the operation. The length of stay in the ICU, hospital stay as well as postoperative complications were significantly reduced in patients with prehabilitation compared with patients not included in the programme. According to these data we can conclude that there was a benefit of our prehabilitation programme, so it would be advisable to include as many patients as possible.