Impact of preoperative change in physical function on postoperative recovery: Argument supporting prehabilitation for colorectal surgery

摘要: Background. Abdominal surgery represents a physiologic stress and is associated with period of recovery during which functional capacity often diminished. ‘‘Prehabilitation’’ program to increase in anticipation an upcoming stressor. We reported recently the results randomized trial comparing 2 prehabilitation programs before colorectal (stationary cycling plus weight training versus recommendation walking coupled breathing exercises); however, adherence was low. The objectives this study were estimate: (1) extent physical function could be improved either identify variables response; (2) impact change preoperative on postoperative recovery. Methods. This involved reanalysis data arising from trial. primary outcome measure measured by Six-Minute Walk Test; secondary outcomes anxiety, depression, health-related quality life, complications (Clavien classification). Multiple linear regression used estimate key predicted over follow-up periods. Results. included 95 people who completed phase (median, 38 days; interquartile range, 22–60), 75 also evaluated postoperatively (mean, 9 weeks). During prehabilitation, 33% their function, 38% stayed within 20 m baseline score, 29% deteriorated. Among those improved, mental health, vitality, self-perceived peak exercise increased significantly. Women less likely improve; low capacity, belief that fitness aids improvements prehabilitation. In phase, patients had more have recovered than no or deterioration (77% vs 59% 32%; P = .0007). Patients deteriorated at greater risk requiring reoperation and/or intensive care management. Significant predictors poorer age >75 years, high intervention, timing assessment. Conclusion. group undergoing scheduled surgery, meaningful changes can achieved several weeks for them, especially poor should consider regimen enhance colectomy. (Surgery 2011;150:505-14.)