Moving from theory to practice: implementing a prehabilitation program before gastrointestinal cancer surgery...

Area of Science:

• Oncology
• Surgical Gastroenterology
• Rehabilitation Medicine

Background:

• Surgery is the primary treatment for early-stage colorectal and upper gastrointestinal (UGI) cancers.
• Postoperative complications and reduced functionality are common challenges following gastrointestinal cancer surgery.
• Prehabilitation programs aim to enhance patients' functional capacity before surgery to mitigate these risks.

Purpose of the Study:

• To evaluate the implementation of a multimodal prehabilitation program for patients undergoing gastrointestinal cancer surgery in a real-world clinical setting.
• To assess the feasibility, adoption, and maintenance of the prehabilitation program.

Main Methods:

• An implementation study utilizing the RE-AIM framework was conducted.
• The program included supervised exercise, nutrition, and nursing support, delivered via face-to-face or telehealth modalities.
• Data were collected at baseline, pre-surgery, and 30 days post-surgery, with comparisons to historical controls.

Main Results:

• 77 out of 91 eligible patients (85%) were recruited, with a median intervention duration of 16 days.
• Significant improvements were observed in quality of life, anxiety, and functional capacity (6-min walk test and 2-min step test).
• Hospital length of stay was reduced by 2.1 days compared to historical controls, with high adherence (94%) and satisfaction.

Conclusions:

• Multimodal prehabilitation is implementable in real-world settings for gastrointestinal cancer patients.
• The program showed a trend towards improved functional and surgical outcomes.
• Dedicated resources are essential for the successful implementation and long-term maintenance of such programs.