Prehabilitation for Gastrointestinal Cancer Surgery

Lambert, Joel and Subar, Daren and Gaffney, Christopher (2024) Prehabilitation for Gastrointestinal Cancer Surgery. In: Recent Strategies in High Risk Surgery :. Springer Nature, Cham. ISBN 9783031562693

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Abstract

Prehabilitation is increasingly being adopted to maximise patient preparedness for surgery. Although there are many forms of prehabilitation, they typically encompass a combination of exercise, nutrition, and psycho-social interventions. There are barriers to the widespread adoption of prehabilitation because of an imbalance between the resources of care systems and the demands placed on them. Mitigations to allow the adoption of prehabilitation include remote prehabilitation and embracing technologies, such as smart watches and apps, although there is limited evidence of their efficacy in the literature. Prehabilitation has documented benefits such as improvements in cardiorespiratory fitness. However, the literature is mixed on outcomes, such as postoperative complications, length of hospital stay, and mortality. There is a spectrum of what prehabilitation should comprise of both in the UK and worldwide, and there remains a debate on what outcomes can be modified given the limited time between diagnosis and surgery.