Improving outcomes in oncological colorectal surgery by prehabilitation

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[DOUBLE HIGH-REVERSED-9 QUOTATION MARK]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: first, to reduce postoperative complications, second, to enhance and accelerate the recovery of the patient and third, to improve overall quality of life. In this article, we introduce the FIT-model illustrating a possible framework towards the implementation of both evidence-based and tailor-made prehabilitation for patients undergoing surgery for colorectal cancer. Results The model is comprised 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). Conclusions Developing implementable methods and defining standardized outcome instruments will help to establish a solid base for patient centered prehabilitation programs. Any party introducing prehabilitation requiring multidisciplinary teamwork and behavioral change can potentially use this framework. Address for correspondence and requests for reprints: Emma RJ Bruns, MD ORCID: 0000-0001-6967-4861, Department of surgery, Academic Medical Centre, PO Box 22660 1100 DD Amsterdam, The Netherlands, Tel: +31-20-56662670 Fax: +31-20-5669243, E-mail: e.r.bruns@amc.nl During review process: e.r.bruns@amc.nl Category: Review Conflicts of interest and source of funding: None Previous presentation of research, manuscript or abstract: None All authors confirm that they have contributed to the submission according to the requirements of the American Journal of Physical Medicine and Prehabilitation Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2PNIXAa
via IFTTT