Functional Assessment and Prehabilitation
- Author(s)
- Ismail, H; Baldini, G; Scheede Bergdahl, C; Carli, F;
- Journal Title
- In: Hagberg, C.A., Gottumukkala, V.N.R., Riedel, B.J., Nates, J.L., Buggy, D.J. (eds) Perioperative Care of the Cancer Patient
- Publication Type
- Book section
- Abstract
- ABSTRACT Cancer and surgery present a significant stress on the body. This stress results in metabolic disturbances, loss of muscle mass, fatigue, anxiety, and subsequent prolonged recovery and increased risk of complications. Preoperative assessments need to take into account not only comorbidities, such as coronary artery disease, hypertension, and diabetes, but also how patients are prepared to deal with the stress of cancer surgery in physical, nutritional, and emotional terms. This is particularly true for those patients at risk, such as the elderly, malnourished, and frail, who have decreased physical reserve and cannot mount a significance response to the stressful events occurring with cancer therapies, surgery, and recovery. The importance of functional assessment using reliable metrics has been further emphasized by our understanding that patients with poor preoperative functional fitness are at higher risk of postoperative complications. Screening patients physically, nutritionally, and emotionally together with medical assessment helps the physician to make a plan and involve the patient in the decision-making process. While the Enhanced Recovery After Surgery (ERAS) protocols emphasize the importance of intraoperative attenuation of the stress response, prehabilitation can be considered a preventative intervention aimed at increasing patient reserve before surgery and contributing to optimizing postoperative outcome. Unimodal and multimodal prehabilitation protocols have demonstrated a positive impact on postoperative recovery of physical fitness and faster return to baseline activities of daily life. The number of studies undertaken in the last 10 years has increased, contributing to a better understanding of how prehabilitation for the cancer patient can be part of the surgical care. The goal of this chapter is to provide an introduction to the components and practical aspects of prehabilitation interventions designed to optimize the patient prior to cancer surgery.
- Publisher
- Elsevier
- Keywords
- Cancer; enhanced recovery pathway; exercise; nutrition; prehabilitation; recovery; surgery
- Department(s)
- Anaesthetics
- Publisher's Version
- https://doi.org/10.1016/B978-0-323-69584-8.00015-3
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-08-20 06:08:25
Last Modified: 2024-08-20 06:56:56