Utility of preoperative exercise therapy in reducing postoperative morbidity after surgery; a clinical overview of current evidence

Re-operation within 30 days of radical cystectomy: Identifying high-risk patients and complications using ACS-NSQIP database

“…A history of COPD was one of the most prominent predictors of reoperation following RC, with a 2.33-fold increased risk of reoperation. Such patients are classically underweight, malnourished, have poor pulmonary reserve, 9 and poor exercise tolerance, 10 which predispose to poor post-operative outcomes. Moreover these patients may have a chronic cough, which may mechanically contribute to poor wound healing.…”

“…Pre-operative rehabilitation/exercise programs for patients with COPD have been proposed by anesthesiologists in an effort to "optimize" respiratory status. 10 This highlights the importance of multispecialty collaboration in the preoperative setting to improve post-operative outcomes. Notably, active smokers did not have significantly increased reoperation rates in our cohort, although this is likely a result of our study sample size/power, as the OR was 1.46 with a 95% CI of 0.99-2.17.…”

“…It has been consistently shown that patients with major post-operative complications following abdominal surgery have almost two fold increased direct hospital costs ($56,224 vs $29,038). 16 Thus, the need for pre-and immediate post-operative efforts, such as preoperative pulmonary rehabilitation programs, 10 extensive counseling regarding importance of weight loss and smoking cessation, and Enhanced Recovery After Surgery (ERAS) pathways, 17 to minimize post-operative complications in high-risk patients, and thus limit financial costs is crucial in this setting.…”

<p>Perioperative Exercise Therapy in Bariatric Surgery: Improving Patient Outcomes</p>

“…In surgical practice, perioperative exercise interventions seem to get more and more attention, due to beneficial effects on complication rate and patient convalescence. Also with the introduction of prehabilitation programs [8][9][10][11]29 and their promising results in various surgical fields it is surprising that exercise interventions in bariatric surgery are so sparsely investigated. In the studies that investigate these perioperative exercise programs, there seems to be a beneficial effect on weight loss parameters, physical activity measurements and risk factors for cardiovascular diseases.…”

“…Among them; optimisation of nutritional status, psychological status and of course improving exercise capacity and physical functioning. Topal et al 29 added one very important aspect, namely the improvement of comorbidities. This is essential since the bariatric surgical patients get older and have potentially more comorbidities with medication use.…”