The Impact of Total Body Prehabilitation on Post‐Operative Outcomes After Major Abdominal Surgery: A Systematic Review

Luther, Alison; Gabriel, Joseph; Watson, Richard P.; Francis, Nader

doi:10.1007/s00268-018-4569-y

Cited by 104 publications

(67 citation statements)

References 51 publications

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“…Review articles have found conflicting results on these programs, mainly due to the heterogeneity of the studies and focus on single risk-factors in the included studies. [258][259][260] At least, the idea of "prehab" does not seem to have any negative outcomes, and international randomised trials are ongoing. 261 Although promising evolvements have been made, the level of postoperative complications in the SCRCR has remained rather stable for the last two decades.…”

Section: Post-operative Complicationsmentioning

confidence: 99%

Tumour regression after radiotherapy for rectal cancer – Results from the randomised Stockholm III trial

Erlandsson

Lörinc

Ahlberg

et al. 2019

Radiotherapy and Oncology

109

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Section: Post-operative Complicationsmentioning

confidence: 99%

Tumour regression after radiotherapy for rectal cancer – Results from the randomised Stockholm III trial

Erlandsson

Lörinc

Ahlberg

et al. 2019

Radiotherapy and Oncology

109

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“…A burgeoning body of research is investigating the utility of preoperative interventions, known as prehabilitation, to optimize posttreatment health outcomes. Numerous reviews of the prehabilitation literature in cancer populations demonstrate several important benefits, including improved preoperative and postoperative physical function, reduced hospital length of stay, and fewer postoperative complications (18)(19)(20)(21)(22)(23)(24). However, this literature exists almost exclusively in people undergoing tumor resection for thoracoabdominal malignancies, with breast cancer prehabilitation remaining largely unexamined.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Prehabilitation Prior to Breast Cancer Surgery: A Mixed-Methods Study

et al. 2020

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Background: Breast cancer surgery results in numerous acute and long-term adverse outcomes; the degree to which these can be mitigated or prevented through prehabilitation is unknown. Methods: We conducted a longitudinal, single-arm, mixed-methods study to examine the feasibility of prehabilitation in 22 women undergoing breast cancer surgery. All participants received an individualized exercise prescription including upper quadrantspecific resistance and mobility training and aerobic exercise for the duration of their surgical wait time. Feasibility was assessed by recruitment, adherence, attrition, and intervention-related adverse event rates. An exploratory investigation of intervention efficacy was conducted via a 6-min walk test, upper-quadrant strength and range of motion, volumetric chances associated with lymphedema, and participant-reported quality of life, fatigue, pain, and disability. Outcome assessments were conducted at baseline, prior to surgery, and at six and 12 weeks after surgery. Semi-structured interviews with a subset of participants (n = 5) and health-care providers (H; n = 2) were conducted to provide further insights about intervention feasibility. Qualitative data were analyzed using a hybrid inductive and deductive thematic analysis approach. Results: Recruitment and attrition rates were 62 and 36%, respectively. Average prehabilitation duration was 31 days (range = 7-69 days). Seventy six percent of participants complied with at least 70% of their prehabilitation prescription. There was a clinically significant increase in the 6-min walk distance from baseline to the preoperative assessment (57 m, 95% CI = −7.52, 121.7). The interviews revealed that the intervention was favorably received by participants and HCPs and included suggestions that prehabilitation (i) should be offered to all surgical candidates, (ii) is an avenue to regain control in the preoperative period, (iii) is a facilitator of postoperative recovery, and (iv) is an opportunity to provide education regarding postoperative rehabilitation protocols. A preference for multimodal prehabilitation (including dietetic and psychological counseling) was also highlighted.

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“…The major interest on this topic of high clinical importance is clearly illustrated by seven very recent systematic reviews and meta-analyses [22,[27][28][29][30][31][32]. Summarizing these results there is significant heterogeneity between studies.…”

Section: Prehabilitationmentioning

confidence: 99%

Is there a rationale for perioperative nutrition therapy in the times of ERAS?

Weimann

2019

Innovative Surgical Sciences

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In order to increase patient compliance in Enhanced Recovery after Surgery (ERAS) programs, assessment and monitoring of functional and nutritional status should be routinely performed. Sarcopenic obesity is frequently underestimated and has been shown to be a significant risk factor for the development of postoperative complications. With special regard to gastrointestinal cancer patients undergoing neoadjuvant treatment, nutritional deficiencies may develop stepwise and increase during therapy. In the case of proven deficits, recent strategies including "prehabilitation" focus on making the patient fit for an ERAS program. Evidence-based guidelines for perioperative nutrition therapy have been available. Zusammenfassung: Auch in Zeiten von ERAS wird die präoperative Erfassung von Ernährungsstatus und Funktionalität mit dem Ziel empfohlen, die Patientencompliance im Programm zu verbessern. Gerade die sarkopene Adipositas wird häufig unterschätzt, hat sich aber als signifikanter Risikofaktor für das Entstehen postoperativer Komplikationen erwiesen. Beim gastrointestinalen Karzinompatienten können sich im Rahmen einer multimodalen Therapie Defizite weiter verstärken, bei deren Vorliegen eine präoperative "Prähabilitation" zu erwägen ist. Unter Einschluss einer Ernährungsintervention zielt die multimodale Prähabilitation auf die Konditionierung für ein ERAS Programm. Evidenz basierte Leitlinien für die perioperative Ernährungstherapie dieser Patienten liegen vor.

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The Impact of Total Body Prehabilitation on Post‐Operative Outcomes After Major Abdominal Surgery: A Systematic Review

Cited by 104 publications

References 51 publications

Tumour regression after radiotherapy for rectal cancer – Results from the randomised Stockholm III trial

Tumour regression after radiotherapy for rectal cancer – Results from the randomised Stockholm III trial

Feasibility of Prehabilitation Prior to Breast Cancer Surgery: A Mixed-Methods Study

Is there a rationale for perioperative nutrition therapy in the times of ERAS?

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