Does Prehabilitation in colorectal cancer surgery improves functional capacity, quality of life and reduce postoperative complications? - A Cochrane Review summary with commentary

Abstract

T he aim of this commentary is to discuss from a rehabilitation perspective the Cochrane Review "Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery" by Molenaar et al. 1 (https://www.cochranelibrary. com/cdsr/doi/10.1002/14651858.CD013259.pub2/full), published by Cochrane Colorectal Group. This Cochrane Corner is produced in agreement with the American Journal of Physical Medicine and Rehabilitation by Cochrane Rehabilitation with views of the review summary authors in the "implications for practice" section.Background: Colorectal cancer is more common in the older people and is considered the fourth most deadly cancer. However, over the past few decades, its incidence in people younger than 50 yrs is increasing. 2 Colorectal cancers are associated with poor health-related quality of life (HRQoL) due to direct consequences of disease (anemia, fatigue, abdominal pain, change in bowel habits) and adverse effects of treatment. 3 Prognosis of colorectal cancer is guarded except for patients with nonmetastatic disease. 3 Surgical resection of tumor is the cornerstone for treatment. 3 There is evidence that postoperative rehabilitation substantially improves functional outcomes and enhance recovery in these patients. 4 However, data regarding the efficacy of multimodal prehabilitation in improving functional status and HRQoL in patients with nonmetastatic colorectal cancer are limited.Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery (Molenaar CJL, van Rooijen SJ, Fokkenrood HJP, Roumen RMH, Janssen L, Slooter GD, 2022). WHAT IS THE AIM OF THIS COCHRANE REVIEW?The aim of this Cochrane Review was to determine the effects of multimodal prehabilitation programs on functional capacity, postoperative outcomes, and HRQoL in patients with colorectal cancer undergoing surgery.

Codesign of health technology interventions to support best-practice perioperative care and surgical waitlist management

“…Considerable progress has been made to define perioperative care as ‘the multidisciplinary, individualised, integrated care of patients’ from initial consideration of surgery to completing postoperative recovery 14. New models of perioperative care, such as geriatric co-management,15 Enhanced Recovery After Surgery16 and prehabilitation,17 are promising approaches to optimise patient outcomes. However, an ongoing unmet need is how healthcare systems can effectively identify patients on surgical waitlists who would benefit most from enhanced perioperative care models 18…”