Prehabilitation programs and ERAS protocols in gynecological oncology: a comprehensive review

PREsurgery thoughts – thoughts on prehabilitation in oncologic gynecologic surgery, a qualitative template analysis in older adults and their healthcare professionals

“…The interviewed healthcare professionals stressed the importance of an evidence-based program before general implementation is possible. Although promising positive results of prehabilitation have been shown [1,2,5], good quality evidence for prehabilitation in the elderly gynecological oncological population is still lacking [13]. Our findings can be used for further research on the effectiveness of prehabilitation.…”

“…Based on previous research [1,2,13], it is necessary to develop an evidence-based prehabilitation program targeted on the elderly gynecologic oncological patients, since current evidence on prehabilitation is lacking in this population. As recommended by Daniels et al, future studies should use methodologies designed for evaluating complex interventions, since prehabilitation programs are complex multi-component interventions [5].…”

“…The gynecological oncological population consists of a large part of frail elderly (around 25% of the patients aged 65 years and older [9]. It would be interesting to investigate if prehabilitation is effective in improving postoperative recovery in this population, since no previous research has been done specifically in older and frail patients undergoing gynecological oncologic surgery, except from one case report [13,14].…”

Enhanced recovery Pathways in gynecologic surgery: Are they safe and effective in the elderly?

“…Johnson et al showed that for patients admitted with cardiovascular disease, adjunctive integrative medicine therapies were associated with significantly less pain and anxiety; and while women had a higher likelihood of receiving integrative medicine therapy, older patients had reduced odds of receiving therapy ( Johnson et al, 2014 ). A systematic review showed that while prehabilitation programs are feasible in gynecologic surgery, the integration of these programs into ERPs has not yet been well established ( Schneider et al, 2020 ). Though physical and occupational therapy may increase the likelihood of early postoperative mobility, especially in the elderly, currently, evidence is lacking in gynecologic ERAS literature and remains a future area of study.…”

Effects of enteral nutrition support combined with enhanced recovery after surgery on the nutritional status, immune function, and prognosis of patients with esophageal cancer after Ivor-Lewis operation

“…ERAS has the goal of achieving rapid postoperative recovery by reducing surgical stress, perioperative organ dysfunction, postoperative complications and shortening hospital stay (18,19). ERAS has been widely applied in the postoperative period of gastrointestinal cancers, such as gastric cancer and colorectal cancer (20).…”