Prehabilitation - Current Role in Surgery

Introduction; Prehabilitation entails preoperative activities designed to properly prepare a patient to undergo surgery and to improve their postoperative recovery. It follows an interdisciplinary approach by improving physical fitness and nourishment status, using mental training and encouraging them to quit addictions. Aim: The aim of the study was to investigate the recent publications in the field of prehabilitation. Methods: We performed a systematic review in the PubMed database using the search term "preopreative OR before surgery, postoperative OR after surgery, prehabilitation". The inclusion criteria were studies with a minimum population of 50 patients, including preoperative interventions, defined with a word prehabilitation, and describing their impact on the postoperative course of the patients. A total of 373 records were returned and 13 studies were finally included in the analysis. Results: According to the selected studies, prehabilitation significantly improves postoperative complication rate, length of hospital stay, postoperative physical activity, treatment costs, perioperative transfusion rate, antibiotic administration, and patients' adherence to postoperative recommendations. On the other hand, no statistically significant impact was found for prehabilitation on quality of life, psychological condition, readmission rate, or reoperations. Discussion: Prehabilitation promotes the development of multimodal care, putting the patient's well-being in the center. Numerous studies have indicated positive results from prehabilitation programs. The final results depend on the prehabilitation protocol, the group of patients, and the standard of care of the center. Conclusion: Prehabilitation is necessary to provide the highest quality of care for a surgical patient. An interdisciplinary approach benefits the patient during the operation as well as in the postoperative period. Every surgical clinic should be aware of the concept of prehabilitation and should possibly create their own programs.