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Exercise prehabilitation in elective intra-cavity surgery: A role within the ERAS pathway? A narrative review

Orange, Samuel T.; Northgraves, Matthew J.; Marshall, Phil; Madden, Leigh A.; Vince, Rebecca V.

Authors

Samuel T. Orange



Abstract

The Enhanced Recovery after Surgery (ERAS) model integrates several elements of perioperative care into a standardised clinical pathway for surgical patients. ERAS programmes aim to reduce the rate of complications, improve surgical recovery, and limit postoperative length of hospital stay (LOHS). One area of growing interest that is not currently included within ERAS protocols is the use of exercise prehabilitation (PREHAB) interventions. PREHAB refers to the systematic process of improving functional capacity of the patient to withstand the upcoming physiological stress of surgery. A number of recent systematic reviews have examined the role of PREHAB prior to elective intra-cavity surgery. However, the results have been conflicting and a definitive conclusion has not been obtained. Furthermore, a summary of the research area focussing exclusively on the therapeutic potential of exercise prior to intra-cavity surgery is yet to be undertaken. Clarification is required to better inform perioperative care and advance the research field. Therefore, this “review of reviews” provides a critical overview of currently available evidence on the effect of exercise PREHAB in patients undergoing i) coronary artery bypass graft surgery (CABG), ii) lung resection surgery, and iii) gastrointestinal and colorectal surgery. We discuss the findings of systematic reviews and meta-analyses and supplement these with recently published clinical trials. This article summarises the research findings and identifies pertinent gaps in the research area that warrant further investigation. Finally, studies are conceptually synthesised to discuss the feasibility of PREHAB in clinical practice and its potential role within the ERAS pathway.

Journal Article Type Review
Publication Date 2018-08
Journal International Journal of Surgery
Print ISSN 1743-9191
Electronic ISSN 1743-9159
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 56
Pages 328-333
APA6 Citation Orange, S. T., Northgraves, M. J., Marshall, P., Madden, L. A., & Vince, R. V. (2018). Exercise prehabilitation in elective intra-cavity surgery: A role within the ERAS pathway? A narrative review. International journal of surgery, 56, 328-333. https://doi.org/10.1016/j.ijsu.2018.04.054
DOI https://doi.org/10.1016/j.ijsu.2018.04.054
Keywords Surgery; General Medicine
Publisher URL https://www.sciencedirect.com/science/article/pii/S1743919118307416
Copyright Statement © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

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Copyright Statement
© 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/



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