Improving Outcomes in Oncological Colorectal Surgery by Prehabilitation

Emma R. J. Bruns*, Stefanus J. van Rooijen, Tanja E. Argillander, Edwin S. van der Zaag, Wilhelmina M. U. van Grevenstein, Peter van Duijvendijk, Christianne J. Buskens, Willem A. Bemelman, Barbara C. van Munster, Gerrit D. Slooter, Baukje van den Heuvel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)

Abstract

Introduction: The cornerstone in the treatment of colorectal cancer is surgery. A surgical event poses a significant risk of decreased functional decline and impaired health-related quality of life. Prehabilitation is defined as the multimodal preoperative enhancement of a patient's condition. It may serve as a strategy to improve postoperative outcomes. Prehabilitation requires a multidisciplinary effort of medical health care professionals and a behavioral change of the patient.

Methods: The goal of prehabilitation is threefold: (1) to reduce postoperative complications, (2) to enhance and accelerate the recovery of the patient, and (3) to improve overall quality of life. In this article, we introduce the FIT model illustrating a possible framework toward the implementation of both evidence-based and tailor-made prehabilitation for patients undergoing surgery for colorectal cancer.

Results: The model is composed of three pillars: "facts" (how to screen patients and evidence on what content to prescribe), "integration" (data of own questionnaires assessing motivation of patients and specialists), and finally "tools" (which outcome measurements to use).

Discussion: Developing implementable methods and defining standardized outcome instruments will help establish a solid base for patient-centered prehabilitation programs. Any party introducing prehabilitation requiring multidisciplinary teamwork and behavioral change can potentially use this framework.

Original languageEnglish
Pages (from-to)231-238
Number of pages8
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume98
Issue number3
DOIs
Publication statusPublished - Mar-2019

Keywords

  • Prehabilitation
  • Colorectal Cancer
  • Surgery
  • RANDOMIZED-CLINICAL-TRIAL
  • 6-MINUTE WALK TEST
  • POSTOPERATIVE OUTCOMES
  • PREOPERATIVE ANEMIA
  • NUTRITIONAL-STATUS
  • ENHANCED RECOVERY
  • PHYSICAL PERFORMANCE
  • ANASTOMOTIC LEAKAGE
  • SURGICAL OUTCOMES
  • INTRAVENOUS IRON

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