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Prehabilitation before general surgery: Worth the effort?

Joshua G Kovoor1,2,3,4, Silas D Nann4,5, Courtney Chambers2,3

  • 1Discipline of Surgery, The University of Adelaide, Adelaide, SA, Australia.

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|December 27, 2023
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Summary

Prehabilitation interventions before surgery show variable benefits for general surgery patients. While physical and pulmonary outcomes may improve, overall effectiveness and optimal approaches require further research.

Keywords:
General surgeryMultidisciplinary careOutcomesPerioperative carePrehabilitation

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Area of Science:

  • General Surgery
  • Perioperative Medicine
  • Rehabilitation

Background:

  • Prehabilitation involves interventions before surgery to enhance patient health and outcomes.
  • The benefits and costs of prehabilitation in general surgery are not definitively established.
  • Patient biopsychosocial health assessment is crucial for tailoring prehabilitation.

Purpose of the Study:

  • To review the current evidence on prehabilitation in general surgery.
  • To identify factors influencing the effectiveness of prehabilitation.
  • To highlight the need for further research on optimal prehabilitation strategies.

Main Methods:

  • Review of existing literature on prehabilitation interventions.
  • Analysis of factors affecting patient engagement and program investment.
  • Emphasis on comprehensive patient assessment including biopsychosocial factors and cardiopulmonary exercise testing.

Main Results:

  • Prehabilitation, particularly multimodal exercise programs, likely improves physical function and pulmonary outcomes.
  • Impact on other surgical outcomes is mixed.
  • Effectiveness is highly variable and depends on numerous factors.

Conclusions:

  • While prehabilitation shows promise for physical and pulmonary improvements, its overall effectiveness in general surgery remains uncertain.
  • Societal factors and investment costs influence program engagement.
  • Further research is essential to determine the full value and optimal implementation of prehabilitation.