Multimodal prehabilitation before major abdominal surgery: A retrospective study

Area of Science:

• Geriatric Medicine
• Surgical Oncology
• Perioperative Care

Background:

• Prehabilitation may improve outcomes for older surgical patients, but evidence is limited.
• Multimodal prehabilitation programs integrate physical, nutritional, and psychosocial support.
• Enhanced Recovery After Surgery (ERAS) pathways aim to optimize surgical patient recovery.

Purpose of the Study:

• To evaluate the efficacy of a multimodal prehabilitation program in older patients undergoing major abdominal surgery.
• To assess the impact of prehabilitation on traditional surgical outcomes and postoperative recovery.
• To investigate prehabilitation's effect on adjuvant therapy adherence in cancer patients.

Main Methods:

• Retrospective review of patients aged 65+ undergoing major abdominal surgery.
• Comparison between a prehabilitation cohort and a control group.
• Prehabilitation included physical therapy, nutritional advice, and psychosocial support within an ERAS framework.

Main Results:

• No significant differences in postoperative length of stay or major complications between groups.
• Prehabilitation patients showed increased postoperative ambulation and physical therapy engagement (postoperative days 1-4).
• In cancer patients, prehabilitation was associated with higher rates of proceeding to adjuvant chemotherapy.

Conclusions:

• Prehabilitation did not alter traditional surgical outcomes but enhanced immediate postoperative mobility.
• Prehabilitation demonstrated an association with improved adherence to adjuvant therapy in cancer patients.
• Further prospective studies are recommended to validate these findings.