Paradigm shift in gastrointestinal surgery − combating sarcopenia with prehabilitation: Multimodal review of clinical and scientific data

A growing body of evidence has demonstrated the prognostic significance of sarcopenia in surgical patients as an independent predictor of postoperative complications and outcomes. These included an increased risk of total complications, major complications, re-admissions, infections, severe infectio...

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Published inWorld journal of gastrointestinal surgery Vol. 13; no. 8; pp. 734 - 755
Main Authors Koh, Frederick H, Chua, Jason MW, Tan, Joselyn LJ, Foo, Fung-Joon, Tan, Winson J, Sivarajah, Sharmini S, Ho, Leonard Ming Li, Teh, Bin-Tean, Chew, Min-Hoe
Format Journal Article
LanguageEnglish
Published Baishideng Publishing Group Inc 27.08.2021
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Summary:A growing body of evidence has demonstrated the prognostic significance of sarcopenia in surgical patients as an independent predictor of postoperative complications and outcomes. These included an increased risk of total complications, major complications, re-admissions, infections, severe infections, 30 d mortality, longer hospital stay and increased hospitalization expenditures. A program to enhance recovery after surgery was meant to address these complications; however, compliance to the program since its introduction has been less than ideal. Over the last decade, the concept of prehabilitation, or “pre-surgery rehabilitation”, has been discussed. The presurgical period represents a window of opportunity to boost and optimize the health of an individual, providing a compensatory “buffer” for the imminent reduction in physiological reserve post-surgery. Initial results have been promising. We review the literature to critically review the utility of prehabilitation, not just in the clinical realm, but also in the scientific realm, with a resource management point-of-view.
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Author contributions: Koh FH and Chua JMW contributed equally to this work; Koh FH, Chua JMW, Teh BT and Chew MH conceptualized the study; Koh FH, Chua JMW performed the review and wrote the manuscript; Tan JLJ, Foo FJ, Tan WJ, Sivarajah SS and Ho LML contributed key inputs to and edited the manuscript; All authors have read and approve the final manuscript.
Corresponding author: Frederick H Koh, FRCS (Ed), MBBS, Assistant Professor, Surgeon, Division of Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Singapore. frederickkohhx@gmail.com
ISSN:1948-9366
1948-9366
DOI:10.4240/wjgs.v13.i8.734