Overcoming Implementation Challenges With Innovation and Patient Empowerment—Let’s Keep Moving With Prehabilitation
Mené entre 2017 et 2020 sur 251 patients atteints d'un cancer colorectal non métastatique et éligibles à la chirurgie (âge médian : 69 ans ; 55 % d'hommes), cet essai randomisé international évalue l'efficacité, du point de vue des complications postopératoires et de la récupération fonctionnelle, d'un programme de préhabilitation multimodale supervisé de 4 semaines (exercices physiques de haute intensité, intervention nutritionnelle, soutien psychologique et sevrage tabagique si nécessaire)
Impaired functional capacity is associated with loss of independence, increased risk of readmission, or death after surgery. The current work by Molenaar et al is the largest randomized clinical trial on multimodal prehabilitation for colorectal cancer surgery to date and provides a robust evidence-based strategy for optimization before surgery. Both intention-to-treat and per-protocol analysis results showed that prehabilitation reduced postoperative complications. Faster and better functional recovery was observed over time. Previous trials have been hampered by lack of sufficient power and heterogeneous design, preventing advancement in the field of prehabilitation. Most importantly, this trial used the untapped resource of patient engagement, an invaluable contribution to the success of this initiative.
JAMA Surgery 2022