Impact of preoperative change in physical function on postoperative recovery: Argument supporting prehabilitation for colorectal surgery

Mayo, Nancy E.; Feldman, Liane S.; Scott, Susan C.; Zavorsky, Gerald S.; Kim, Do Jun; Charlebois, Patrick; Stein, Barry; Carli, Francesco

doi:10.1016/j.surg.2011.07.045

Cited by 381 publications

(268 citation statements)

References 32 publications

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“…This study uses a trimodal approach of preoperative exercise, nutritional intervention (dietary behavior counseling and protein supplementation) and anxiety reduction training (also aimed at increasing compliance of exercise and nutritional intervention). Multimodal approaches have yielded promising preliminary results such as better walking capacity in weeks after surgery and higher physical activity levels after surgery compared to controls [46,47] . Because in Western society gastric cancer is predominantly a disease of the elderly prehabilitation may provide a promising effort for improving outcomes in these patients in the future [48] .…”

Section: Mustmentioning

confidence: 99%

Improving the outcomes in gastric cancer surgery

Tegels¹,

Maat²,

Hulsewé³

et al. 2014

WJG

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Section: Mustmentioning

confidence: 99%

Improving the outcomes in gastric cancer surgery

Tegels¹,

Maat²,

Hulsewé³

et al. 2014

WJG

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“…Prehabilitation aims to improve outcomes after surgery by improving the patient's physiologic reserve (discussed elsewhere in this issue). 25 The anesthesiologist must deliver a suitable anesthetic from which the patient can awaken rapidly with minimal pain, avoiding postoperative nausea and vomiting, and in a fluid-optimized state. Reducing secondary injury is done by modulating the stress response by effective analgesia and early oral intake of food, which stops the catabolic response and promotes anabolism and healing.…”

Section: The Enhanced Recovery Pathway and Role Of The Anesthesiologistmentioning

confidence: 99%

Pathophysiology of Major Surgery and the Role of Enhanced Recovery Pathways and the Anesthesiologist to Improve Outcomes

Scott

Miller

2015

Anesthesiology Clinics

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KEYWORDSEnhanced recovery pathway Fast-track surgery Anesthesia Perioperative care Pathophysiology of surgery Stress response to surgery Metabolic response to surgery Minimally invasive surgery KEY POINTSEnhanced recovery pathways aim to reduce the stress response and improve the metabolic response to surgery restoring the patient to preoperative function more quickly.It is increasingly recognized that rapid, uncomplicated, recovery reduces not only the cost and length of stay of the patient episode but medical and possibly surgical related complications. Provided defined discharge criteria are met readmission rates are not increased.Minimally invasive surgery is a key component of enhanced recovery to reduce the primary injury of tissue damage and blood loss, which both drive the stress response and metabolic response to surgery.All elements of an enhanced recovery pathway are important because they interact positively with each other, a term likened to the sum of small gains.The anesthesiologist plays a key role in optimizing surgical outcomes by controlling a patient's physiology throughout the perioperative pathway.Anesthesiology Clin 33 (2015) 79-91 http://dx

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“…We identified 14 randomised controlled trials investigating either physical activity or diet/excess body weight, or both, in patients with colorectal cancer -there were no randomised controlled trials investigating smoking or alcohol consumption [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. The interventions consisted mainly of telephone-prompted walking or cycling interventions and were mostly in the adjuvant setting.…”

Section: Feasibilitymentioning

confidence: 99%

Commentary on Lifestyle Interventions Are Feasible in Patients with Colorectal Cancer with Potential Short-Term Health Benefits

Bryce¹,

Moug²

2017

J Comm Pub Health Nurs

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The problemWith the increasing incidence and heavy disease burden of colorectal cancer, there is a new need to improve the quality and length of survivorship in patients with this illness. The management of colorectal cancer involves multi-disciplinary working through multimodal treatment pathways and in itself has significant effects on the physical and psychological health of patients. Major surgery, adjuvant and neo-adjuvant chemotherapy and radiotherapy, and the possibility of a stoma are included in the list of challenges patients must overcome in their journey through the treatment of this illness.One such strategy to improve the quality and length of survivorship is lifestyle interventions. Modification of lifestyle factors has been shown to play a role in reducing the risk of developing colorectal cancer, including modifications in excess weight, poor diet, smoking, alcohol excess and physical inactivity [1][2][3][4][5][6]. However, given the difficulty in performing randomised controlled trials in lifestyle interventions in colorectal cancer, there is doubt about the feasibility of such interventions [7,8]. With this in mind, we have recently published a systematic review [9] which sought to collate the evidence for the feasibility of performing lifestyle factor interventions in patients with colorectal cancer, allowing conclusions on the short and long-term health benefits to be drawn. FeasibilityWe identified 14 randomised controlled trials investigating either physical activity or diet/excess body weight, or both, in patients with colorectal cancer -there were no randomised controlled trials investigating smoking or alcohol consumption [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. The interventions consisted mainly of telephone-prompted walking or cycling interventions and were mostly in the adjuvant setting. Dietary interventions focused on low-fat, high-fibre diets and were mostly part of multi-modal lifestyle interventions. We noted a low drop-out rate among these interventions, suggesting they are feasible. Although the majority were performed in the adjuvant setting, we also noted interventions being performed in the neo-adjuvant setting (including pre-habilitation) and even many years after completion of treatment. Short-term outcomes and crossover benefitsIn addition to a low drop-out rate among these randomised controlled trials we also noted shortterm improvements in both physical health (dietary quality, physical fitness) and quality of life. It should also be mentioned that many of these trials recruited from populations of patients with no one individual cancer, i.e. not specifically colorectal cancer. These findings reinforce the importance of correcting lifestyle factors not solely in colorectal cancer, but in many other cancers. Furthermore, given the well-documented and widely accepted role of lifestyle factors in the development of many other widespread diseases (cardiovascular disease, cerebrovascular disease, diabetes) [26], any lifestyle interventions to improv...

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Impact of preoperative change in physical function on postoperative recovery: Argument supporting prehabilitation for colorectal surgery

Cited by 381 publications

References 32 publications

Improving the outcomes in gastric cancer surgery

Improving the outcomes in gastric cancer surgery

Pathophysiology of Major Surgery and the Role of Enhanced Recovery Pathways and the Anesthesiologist to Improve Outcomes

Commentary on Lifestyle Interventions Are Feasible in Patients with Colorectal Cancer with Potential Short-Term Health Benefits

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