Exploring Psychological Prehabilitation in Complex Abdominal Wall Reconstruction: A Prospective Pilot Study.

Area of Science:

• Surgical Oncology
• Psychological Medicine
• Hernia Repair

Background:

• Prehabilitation for complex abdominal wall hernias (CAWR) typically focuses on physical aspects.
• Psychological factors such as anxiety, depression, and PTSD are prevalent but understudied in this patient group.
• These psychological comorbidities can significantly impact recovery, complications, and quality of life.

Purpose of the Study:

• To investigate the prevalence of psychological comorbidities in patients scheduled for CAWR.
• To explore the association between psychological factors and postoperative outcomes.

Main Methods:

• A prospective cohort study involving patients undergoing CAWR.
• Preoperative assessment using validated questionnaires for anxiety, depression (HADS), PTSD (PCL-5), self-efficacy (Mastery), and quality of life (QoL).
• Exploration of associations between psychological factors and postoperative pain, opioid use, length of stay, and complications.

Main Results:

• Sixty-nine percent of participants screened positive for at least one psychological risk factor.
• Prevalence included 60% for anxiety/depression, 13% for PTSD, and 53% for low self-efficacy.
• A correlation was observed between psychological comorbidities and prolonged postoperative pain.

Conclusions:

• A high threshold to participate was noted, with two-thirds of assessed patients experiencing psychological comorbidities.
• Psychological comorbidities appear to be a clinically relevant risk factor in CAWR patients.
• Further research is needed to understand the role of psychological factors and evaluate psychological prehabilitation interventions.