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E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Published on: August 1, 2019

Prehabilitation Prior to Colorectal Cancer Surgery: Impact and Implementation.

Elize W Lockhorst^1,2, Theresia A M Backhuijs³, Teun M E Kerkhoff⁴

¹Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands.

Journal of Surgical Oncology

|June 18, 2026

Summary

This summary is machine-generated.

Standardised prehabilitation improved participation and fitness for colorectal cancer surgery patients. This safe approach enhanced outcomes, reducing hospital stays without increasing complications.

Keywords:

colorectal surgery implementation prehabilitation standardised protocol surgical outcomes

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E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Published on: August 1, 2019

Area of Science:

Oncology
Surgical Outcomes
Rehabilitation Medicine

Background:

Multimodal prehabilitation aims to enhance surgical outcomes and preoperative fitness in colorectal cancer (CRC) patients.
Implementation of a standardized prehabilitation program for elective CRC surgery was evaluated.
The study identified implementation pitfalls and challenges.

Purpose of the Study:

To assess the impact of a standardized multimodal prehabilitation program for elective colorectal cancer surgery.
To evaluate the implementation process, including pitfalls and challenges.
To determine the effect on patient outcomes and preoperative fitness.

Main Methods:

A retrospective, single-centre study included colorectal cancer patients scheduled for resection between January 2022 and April 2024.
A standardized multimodal prehabilitation program was introduced in May 2023.
Patients were divided into prehabilitation and non-prehabilitation groups for comparison of clinical data and outcomes.

Main Results:

Participation in prehabilitation increased significantly after standardization (40% to 59%).
Prehabilitation led to significant improvements in patient strength and physical fitness (leg press, steep ramp).
Standardized prehabilitation was associated with a shorter postoperative hospital stay (3 vs. 4 days) and similar complication rates despite higher comorbidity burden.

Conclusions:

Standardized prehabilitation is beneficial and safe for colorectal cancer patients.
The program improved participation, referral justification, and patient outcomes.
High-risk colorectal cancer patients particularly benefit from standardized prehabilitation.