Preoperative exercise and prehabilitation. Issue 6 (27th December 2022)

• Record Type: Journal Article
• Authors: Esser, Tobias; Zimmer, Philipp; Schier, Robert
• Is Part Of: Current opinion in anaesthesiology. Volume 35:Issue 6(2022)
• Page Start: 667
• Page End: 673
• Publication Date: 2022-12-27
• Subjects: cellular mechanisms induced by preoperative exercise -- current prehabilitation studies -- impact of prehabilitation on perioperative outcome -- preoperative physical exercise; Anesthesiology -- Periodicals; Anesthesiology -- Indexes; Anesthesiology -- Periodicals; Review Literature -- Indexes; Review Literature -- Periodicals; Anesthesiology; Periodicals; 617.9605
• DOI: 10.1097/ACO.0000000000001188
• Languages: English
• ISSNs: 0952-7907

Abstract

Abstract : Purpose of review: The purpose of this narrative review is to give an overview about the effects of multimodal prehabilitation and current existing and prospectively planned studies. The potential efficacy of exercise in the context of prehabilitation ranges from preoperatively improving patients' functional capacity to inducing cellular mechanisms that affect organ perfusion via endothelial regeneration, anti-inflammatory processes and tumour defense. Recent findings: Current studies show that prehabilitation is capable of reducing certain postoperative complications and length of hospital stay in certain patient populations. These findings are based on small to mid-size trials with large heterogeneity, lacking generalizability and evidence that prehabilitation has positive effects on long term survival. Summary: The concept of prehabilitation contains the features, namely preoperative exercise, nutritional intervention and psychological support. Preoperative exercise holds potential molecular effects that can be utilized in the perioperative period in order to improve patients' postoperative outcome. Future multimodal prehabilitation trials must specifically clarify the clinical impact of this concept on patients' quality of life after major cancer surgery and cancer-specific survival.