Utilidad de la prehabilitación en cancer colorectal
DOI:
https://doi.org/10.26754/ojs_arcol/archcolo.202115448Keywords:
cirugía colorrectal, prehabilitaciónAbstract
Se estima que en España en 2020 se diagnosticarán 44 231 nuevos casos de cáncer colorectal y la cirugía tiene un papel clave en el tratamiento con intención curativa. Una baja capacidad funcional está relacionada con una mayor morbimortalidad y una recuperación postoperatoria lenta. La prehabilitación es un conjunto de medidas que tienen por objetivo aprovechar el período preoperatorio para prevenir o atenuar el deterioro funcional relacionado con la cirugía y sus consecuencias. La forma más habitual de realizarla es la trimodal, con intervenciones a nivel de capacidad física, estado nutricional y soporte psicológico. Hasta la fecha se han publicado pocos ensayos clínicos aleatorizados en cirugía colorectal y hay cierta dificultad para elegir un parámetro que permita concluir su eficacia. Sin embargo, la evidencia disponible sugiere que la prehabilitación tiene efectos beneficiosos en la reducción de las complicaciones y acelerar la recuperación postoperatoria y se podría plantear su uso en forma sistemática.
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References
El cáncer en cifras - SEOM: Sociedad Española de Oncología Médica © 2019. https://seom.org/publicaciones/el-cancer-en-espanyacom. Accessed December 17, 2020.
Ven Fong Z, Chang DC, Lillemoe KD, Nipp RD, Tanabe KK, Qadan M. Contemporary Opportunity for Prehabilitation as Part of an Enhanced Recovery after Surgery Pathway in Colorectal Surgery. Clin Colon Rectal Surg. 2019;32(2):95-101. doi:10.1055/s-0038-1676473
Minnella EM, Carli F. Prehabilitation and functional recovery for colorectal cancer patients. Eur J Surg Oncol. 2018;44(7):919-926. doi:10.1016/j.ejso.2018.04.016
Hughes MJ, Hackney RJ, Lamb PJ, Wigmore SJ, Christopher Deans DA, Skipworth RJE. Prehabilitation Before Major Abdominal Surgery: A Systematic Review and Meta-analysis. World J Surg. 2019;43(7):1661-1668. doi:10.1007/s00268-019-04950-y
Heger P, Probst P, Wiskemann J, Steindorf K, Diener MK, Mihaljevic AL. A Systematic Review and Meta-analysis of Physical Exercise Prehabilitation in Major Abdominal Surgery (PROSPERO 2017 CRD42017080366). J Gastrointest Surg. 2020;24(6):1375-1385. doi:10.1007/s11605-019-04287-w
Gillis C, Gramlich L, Culos-Reed SN, et al. Third-Variable Effects: Tools to Understand Who, When, Why, and How Patients Benefit From Surgical Prehabilitation. J Surg Res. 2020. doi:10.1016/j.jss.2020.09.026
Gillis C, Buhler K, Bresee L, et al. Effects of Nutritional Prehabilitation, With and Without Exercise, on Outcomes of Patients Who Undergo Colorectal Surgery: A Systematic Review and Meta-analysis. Gastroenterology. 2018;155(2):391-410.e4. doi:10.1053/j.gastro.2018.05.012
Carli F, Charlebois P, Stein B, et al. Randomized clinical trial of prehabilitation in colorectal surgery. Br J Surg. 2010;97(8):1187-1197. doi:10.1002/bjs.7102
Carli F, Bessissow A, Awasthi R, Liberman S. Prehabilitation: finally utilizing frailty screening data. Eur J Surg Oncol. 2020;46(3):321-325. doi:10.1016/j.ejso.2020.01.001
López Rodríguez-Arias F, Sánchez-Guillén L, Armañanzas Ruiz LI, et al. A Narrative Review About Prehabilitation in Surgery: Current Situation and Future Perspectives. Cir Esp. 2020;98(4):178-186. doi:10.1016/j.ciresp.2019.11.005
Leong KJ, Chapman MAS. Current data about the benefit of prehabilitation for colorectal cancer patients undergoing surgery are not sufficient to alter the NHS cancer waiting targets. Color Dis. 2017;19(6):522-524. doi:10.1111/codi.13723
Strous MTA, Janssen-Heijnen MLG, Vogelaar FJ. Impact of therapeutic delay in colorectal cancer on overall survival and cancer recurrence – is there a safe timeframe for prehabilitation? Eur J Surg Oncol. 2019;45(12):2295-2301. doi:10.1016/j.ejso.2019.07.009
Curtis NJ, West MA, Salib E, et al. Time from colorectal cancer diagnosis to laparoscopic curative surgery—is there a safe window for prehabilitation? Int J Colorectal Dis. 2018;33(7):979-983. doi:10.1007/s00384-018-3016-8
Carli F, Bousquet-Dion G, Awasthi R, et al. Effect of Multimodal Prehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer: A Randomized Clinical Trial. JAMA Surg. 2020;155(3):233-242. doi:10.1001/jamasurg.2019.5474
Lambert J, Hayes L, Keegan T, Subar D, Gaffney C. The Impact of Prehabilitation on Patient Outcomes in Hepatobiliary, Colorectal, and Upper Gastrointestinal Cancer Surgery: A PRISMA-Accordant Meta-Analysis. Ann Surg. November 2020. doi:10.1097/SLA.0000000000004527
Gillis C, Li C, Lee L, et al. Prehabilitation versus rehabilitation: A randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology. 2014;121(5):937-947. doi:10.1097/ALN.0000000000000393
Bousquet-Dion G, Awasthi R, Loiselle SÈ, et al. Evaluation of supervised multimodal prehabilitation programme in cancer patients undergoing colorectal resection: a randomized control trial. Acta Oncol (Madr). 2018;57(6):849-859. doi:10.1080/0284186X.2017.1423180
Kim DJ, Mayo NE, Carli F, Montgomery DL, Zavorsky GS. Responsive measures to prehabilitation in patients undergoing bowel resection surgery. Tohoku J Exp Med. 2009;217(2):109-115. doi:10.1620/tjem.217.109
Mayo NE, Feldman L, Scott S, et al. Impact of preoperative change in physical function on postoperative recovery: Argument supporting prehabilitation for colorectal surgery. Surgery. 2011;150(3):505-514. doi:10.1016/j.surg.2011.07.045
Gillis C, Loiselle SE, Fiore JF, et al. Prehabilitation with Whey Protein Supplementation on Perioperative Functional Exercise Capacity in Patients Undergoing Colorectal Resection for Cancer: A Pilot Double-Blinded Randomized Placebo-Controlled Trial. J Acad Nutr Diet. 2016;116(5):802-812. doi:10.1016/j.jand.2015.06.007
Gillis C, Fenton TR, Sajobi TT, et al. Trimodal prehabilitation for colorectal surgery attenuates post-surgical losses in lean body mass: A pooled analysis of randomized controlled trials. Clin Nutr. 2019;38(3):1053-1060. doi:10.1016/j.clnu.2018.06.982
Awasthi R, Minnella EM, Ferreira V, Ramanakumar A V., Scheede-Bergdahl C, Carli F. Supervised exercise training with multimodal pre-habilitation leads to earlier functional recovery following colorectal cancer resection. Acta Anaesthesiol Scand. 2019;63(4):461-467. doi:10.1111/aas.13292
Gillis C, Fenton TR, Gramlich L, et al. Older frail prehabilitated patients who cannot attain a 400 m 6-min walking distance before colorectal surgery suffer more postoperative complications. Eur J Surg Oncol. 2020. doi:10.1016/j.ejso.2020.09.041
Northgraves MJ, Arunachalam L, Madden LA, et al. Feasibility of a novel exercise prehabilitation programme in patients scheduled for elective colorectal surgery: a feasibility randomised controlled trial. Support Care Cancer. 2020;28(7):3197-3206. doi:10.1007/s00520-019-05098-0
Moug SJ, Mutrie N, Barry SJE, et al. Prehabilitation is feasible in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy and may minimize physical deterioration: results from the REx trial. Color Dis. 2019;21(5):548- 562. doi:10.1111/codi.14560
Dronkers JJ, Lamberts H, Reutelingsperger IMMD, et al. Preoperative therapeutic programme for elderly patients scheduled for elective abdominal oncological surgery: A randomized controlled pilot study. Clin Rehabil. 2010;24(7):614-622. doi:10.1177/0269215509358941
Van Rooijen S, Carli F, Dalton S, et al. Multimodal prehabilitation in colorectal cancer patients to improve functional capacity and reduce postoperative complications: The first international randomized controlled trial for multimodal prehabilitation. BMC Cancer. 2019;19(1). doi:10.1186/s12885-018-5232-6
Berkel AEM, Bongers BC, van Kamp MJS, et al. The effects of prehabilitation versus usual care to reduce postoperative complications in high-risk patients with colorectal cancer or dysplasia scheduled for elective colorectal resection: Study protocol of a randomized controlled trial. BMC Gastroenterol. 2018;18(1). doi:10.1186/s12876-018-0754-6
Wong SG, Maida E, Harvey D, Wagner N, Sonnadara R, Amin N. Evaluation of a physiatrist-directed prehabilitation intervention in frail patients with colorectal cancer: A randomised pilot study protocol. BMJ Open. 2017;7(6). doi:10.1136/bmjopen-2016-015565
Onerup A, Angenete E, Bock D, et al. The effect of pre- and post-operative physical activity on recovery after colorectal cancer surgery (PHYSSURG-C): Study protocol for a randomised controlled trial. Trials. 2017;18(1). doi:10.1186/s13063-017-1949-9
Barberan-Garcia A, Ubré M, Roca J, et al. Personalised Prehabilitation in High- risk Patients Undergoing Elective Major Abdominal Surgery : A Randomized Blinded Controlled Trial. Ann Surg. 2018;267(1):50-56. doi:10.1097/SLA.0000000000002293
Bruns ERJ, van den Heuvel B, Buskens CJ, et al. The effects of physical prehabilitation in elderly patients undergoing colorectal surgery: a systematic review. Color Dis. 2016;18(8):O267-O277. doi:10.1111/codi.13429
Moran J, Guinan E, McCormick P, et al. The ability of prehabilitation to influence postoperative outcome after intra-abdominal operation: A systematic review and meta-analysis. Surg (United States). 2016;160(5):1189-1201. doi:10.1016/j.surg.2016.05.014
Le Roy B, Slim K. Is prehabilitation limited to preoperative exercise? Surg (United States). 2017;162(1):192. doi:10.1016/j.surg.2016.10.039
Fulop A, Lakatos L, Susztak N, Szijarto A, Banky B. The effect of trimodal prehabilitation on the physical and psychological health of patients undergoing colorectal surgery: a randomised clinical trial. Anaesthesia. 2020. doi:10.1111/anae.15215
Van Rooijen SJ, Molenaar CJL, Schep G, et al. Making Patients Fit for Surgery: Introducing a Four Pillar Multimodal Prehabilitation Program in Colorectal Cancer. Am J Phys Med Rehabil. 2019;98(10):888-896. doi:10.1097/PHM.0000000000001221
Scheede-Bergdahl C, Minnella EM, Carli F. Multi-modal prehabilitation: addressing the why, when, what, how, who and where next? Anaesthesia. 2019;74:20-26. doi:10.1111/anae.14505
Orange ST, Northgraves MJ, Marshall P, Madden LA, Vince R V. Exercise prehabilitation in elective intra-cavity surgery: A role within the ERAS pathway? A narrative review. Int J Surg. 2018;56:328-333. doi:10.1016/j.ijsu.2018.04.054
van Rooijen SJ, Engelen MA, Scheede-Bergdahl C, et al. Systematic review of exercise training in colorectal cancer patients during treatment. Scand J Med Sci Sport. 2018;28(2):360-370. doi:10.1111/sms.12907
Calvo Vecino JM, del Valle Hernandez E, Ramirez Jimenez JM, Loinaz Segurola C, Trapero CM. Vía Clínica de Recuperación Intensifcada (RICA). Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad e Instituto Aragonés de Ciencias de la Salud; 2015. papers2://publication/uuid/498C26B6-069C-4E5A-B16C-BEAB6C6461A5.
Mora López L, Pallisera Llovera A, Serra-Aracil X, et al. A single-center prospective observational study on the effect of trimodal prehabilitation in colorectal surgery. Cir Esp. 2020. doi:10.1016/j.ciresp.2020.03.023
Topp R, Ditmyer M, King K, Doherty K, Hornyak J. The effect of bed rest and potential of prehabilitation on patients in the intensive care unit. AACN Clin Issues. 2002;13(2):263-276. doi:10.1097/00044067-200205000-00011
Carli F, Zavorsky GS. Optimizing functional exercise capacity in the elderly surgical population. Curr Opin Clin Nutr Metab Care. 2005;8(1):23-32. doi:10.1097/00075197-200501000-00005
Moriello C, Mayo NE, Feldman L, Carli F. Validating the Six-Minute Walk Test as a Measure of Recovery After Elective Colon Resection Surgery. 2008. doi:10.1016/j.apmr.2007.11.031
Crapo RO, Casaburi R, Coates AL, et al. ATS statement: Guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-117. doi:10.1164/ajrccm.166.1.at1102
Weimann A, Braga M, Carli F, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36(3):623-650. doi:10.1016/j.clnu.2017.02.013
Jie B, Jiang ZM, Nolan MT, Zhu SN, Yu K, Kondrup J. Impact of preoperative nutritional support on clinical outcome in abdominal surgical patients at nutritional risk. Nutrition. 2012;28(10):1022-1027. doi:10.1016/j.nut.2012.01.017
Burden S, Todd C, Hill J, Lal S. Pre-operative Nutrition Support in Patients Undergoing Gastrointestinal Surgery. Cochrane Database Syst Rev. 2012;11. doi:10.1002/14651858.cd008879.pub2
Yu K, Zheng X, Wang G, et al. Immunonutrition vs Standard Nutrition for Cancer Patients: A Systematic Review and Meta-Analysis (Part 1). J Parenter Enter Nutr. 2020;44(5):742-767. doi:10.1002/jpen.1736
Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr. 2002;56(8):779-785. doi:10.1038/sj.ejcn.1601412
Strong for Surgery. https://www.facs.org/quality-programs/strong-for-surgery. Accessed December 10, 2020.
Englesbe MJ, Grenda DR, Sullivan JA, et al. The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs. Surg (United States). 2017;161(6):1659-1666. doi:10.1016/j.surg.2016.12.021
Lee L, Mata J, Ghitulescu GA, et al. Cost-effectiveness of enhanced recovery versus conventional perioperative management for colorectal surgery. Ann Surg. 2015;262(6):1026-1033. doi:10.1097/SLA.0000000000001019
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Copyright (c) 2021 Gerardo Rodríguez León, Manolo León Valarezo
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