Feasibility of setting up a pre-operative optimisation 'pre-hab' service for lung cancer surgery in the UK

Pre-operative optimisation 'pre-hab' is a growing area in peri-operative medicine. This is usually undertaken with the aim of reducing post-operative complications. In the case of early-stage lung cancer, surgery is the treatment modality with the best-proven cure rates. With this in mind, we set up a pre-hab service, not merely to reduce the risk of post-operative complications, but to enable patients of borderline fitness for surgery to safely undergo this potentially lifesaving treatment. We believe this service to be one of the first of its kind in the UK, here we describe the challenges we faced in setting it up and the outcomes from our first 50 patients.