Optimization of surgical outcomes with prehabilitation

Author:

Santa Mina Daniel12,Scheede-Bergdahl Celena34,Gillis Chelsia35,Carli Francesco35

Affiliation:

1. ELLICSR, Princess Margaret Cancer Centre, 585 University Avenue, Munk Building, BCS021, Toronto, ON M5G 2C4, Canada.

2. Kinesiology Program, University of Guelph-Humber, Toronto, ON, Canada.

3. Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W 1S4, Canada.

4. Department of Anesthesia, McGill University, Montreal, QC H4A 3J1, Canada.

5. McGill University Health Centre, 1650 Cedar Ave., Rm D10.14, Montreal, QC H3G 1A4, Canada.

Abstract

The concept of preparing surgical candidates with various modalities designed to increase physical, physiological, metabolic, and psychosocial reserves is known as prehabilitation. Prehabilitation has garnered significant attention in recent years as evidence grows describing benefits to clinical and quality of life outcomes. Recent research examining hospital length of stay and readmission rates provides promising findings with respect to the value of prehabilitation in economic and sustainable healthcare models. The role of prehabilitation across the surgical experience exploits common surgical wait-times and the teachable moment that many patients experience upon the identification of a surgical requirement to improve the pre-, peri-, and postoperative experience. Prehabilitation incorporates numerous systemic and regional approaches to conditioning the surgical candidate. These include exercise, nutrition, education, and/or psychosocial approaches that are intended to improve preoperative fitness and preparedness. Importantly, this also promotes and facilitates health behaviour changes not only preoperatively but during the postoperative period and over the long-term. In this paper, we briefly review the historical and current perspectives on prehabilitation and comment on opportunities for greater clinical and empirical understanding in this field.

Publisher

Canadian Science Publishing

Subject

Physiology (medical),Nutrition and Dietetics,Physiology,General Medicine,Endocrinology, Diabetes and Metabolism

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