Prehabilitation for Elective Abdominal Surgery: Fundamentals and Outcomes
Posted in Lectures on 15 November 2018
F. Borja De Lacy
Major abdominal surgery is associated with a high rate of postoperative complications. Postoperative reduction of functional capacity is observed in patients undergoing major abdominal surgery, even in the absence of complications.
Prehabilitation in patients undergoing major abdominal surgery has been demonstrated to be an effective preventive intervention to reduce postoperative complications. Its goal is to enhance aerobic capacity, through supervised endurance exercise training and promotion of physical activity. Elderly patients with multiple comorbidities are prone to perioperative complications and, consequently, they are the most likely to benefit from prehabilitation programs.
The Barberan-García and colleagues’ group conducted a randomized blind controlled trial assessing the impact of a prehabilitation intervention on perioperative complications in high-risk patients undergoing major abdominal surgery. The design of the study and the reported outcomes are discussed. Prehabilitation was found to be a protective factor for postoperative complications [RR 0.5, 95% confidence interval (CI), 0.3–0.8], and may be recommended for selected patients under an evidence-based source.