Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery

Molenaar, Charlotte J L; Rooijen, Stefan J van; Fokkenrood, H.J.P.; Roumen, R. M. H.; Janssen, Loes; Slooter, Gerrit D.

doi:10.1002/14651858.cd013259.pub2

Cited by 70 publications

(73 citation statements)

References 91 publications

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“…The failure to reduce significantly postoperative overall morbidity after prehabilitation for colorectal surgery is not new and it is well reported in several published papers. To note, the last Cochrane review including only 3 Canadian trials, showed, with a low certainty of evidence, that prehabilitation "may reduce" the postoperative complications rate but conversely increases the readmission rate [2]. The absence of selection of high-risk or frail or older patients in most published works as in the present paper [1] can explain the absence of significant effect in the prehabilitation group.…”

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confidence: 59%

Prehabilitation: better for selected patients

Slim¹

2022

Langenbecks Arch Surg

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confidence: 59%

Prehabilitation: better for selected patients

Slim¹

2022

Langenbecks Arch Surg

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“…A recent review of studies on cancer prehabilitation found an improvement in the reported quality of life of patients with prostate cancer with no progress in functional ability or distress and an improvement in the quality of life of breast cancer patients [ 9 ]. A Cochrane review looking at prehabilitation programmes for colorectal patients found an improved functional capacity and fewer complications, but studies included in the review did not report outcomes in quality of life and overall were of low quality, so the certainty of the evidence was also low [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Cost Analysis of a Digital Multimodal Cancer Prehabilitation

Gkaintatzi

Nikolaou

Rampal³

et al. 2022

Current Oncology

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Introduction: There is growing evidence that prehabilitation programmes effectively improve the physical and psychological conditions of cancer patients awaiting treatment. During the pandemic, people with cancer were classed as vulnerable. To reduce risk to this population Kent and Medway Prehabilitation service transformed into a TeleHealth format. The aim of this study is to assess the impact on health-related quality of life (HRQoL) and the costs of a digital multimodal prehabilitation programme. Methods: HRQoL was measured with the EQ-5D and quality-adjusted life years (QALYs) were calculated. Costs of the prehabilitation service and inpatient care were calculated. Comparisons were made between different levels of prehabilitation received. Results: A sample of 192 individuals was included in the study Mean HRQoL improved from 69.53 at baseline to 85.71 post-rehabilitation, a 23% increase. For each additional week of prehabilitation care in cancer patients, the model predicts that the total QALYS increase by 0.02, when baseline utility is held constant. Conclusions: Prehabilitation is associated with improved HRQoL and QALYs. Our model of a multimodal digital prehabilitation program can be beneficial for patients and reduce costs for healthcare facilities even when the patients attend only a few sessions.

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“…The evidence in this regard is still the subject of current discussion. A good review was carried out within the framework of a Cochrane review [34].…”

Section: Modification Of Individual Protocol Elementsmentioning

confidence: 99%

Patient-Tailored Approach for Enhanced Recovery after Surgery

et al. 2022

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Background: Enhanced recovery after surgery (ERAS®) is increasingly finding its way into clinical practice. ERAS® protocols have not been universally adopted, and they have often been criticized for being difficult to implement. So, the question for more tailor-made approaches arises. Methods: We conducted a literature search on March 16, 2022, using the following search string, which was modified to fit the input of each of the queried databases: (“ERAS®” or “enhanced recovery after surgery” or “fast recovery” or “fast track”) and (“tailored” or “individual”). Results: Despite the massive increase in general hits on the subject, stratification according to phenotypic characteristics such as age or a classification according to disease patterns in the sense of specific guidelines is still fundamentally apparent. Evidence suggests that generic protocols can be followed by almost all patients. Prehabilitation, in particular, can be used as an adaptive tool. Conclusion: ERAS® works only in the totality of its tools and can be followed by almost all patients. Prehabilitation is more adaptive and can also increase adherence to ERAS® protocols. A tailored program outside of disease-specific pathways does not seem to be useful.

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Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery

Cited by 70 publications

References 91 publications

Prehabilitation: better for selected patients

Prehabilitation: better for selected patients

Cost Analysis of a Digital Multimodal Cancer Prehabilitation

Patient-Tailored Approach for Enhanced Recovery after Surgery

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