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. 2023 Mar 20;15(6):1870.
doi: 10.3390/cancers15061870.

Multimodal Prehabilitation in Patients Undergoing Complex Colorectal Surgery, Liver Resection, and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): A Pilot Study on Feasibility and Potential Efficacy

Dieuwke Strijker  1 , Wilhelmus J H J Meijerink  2 , Linda A G van Heusden-Schotalbers  3 , Manon G A van den Berg  4 , Monique J M D van Asseldonk  4 , Luuk D Drager  2 , Johannes H W de Wilt  1 , Kees J H M van Laarhoven  1 , Baukje van den Heuvel  2
Affiliations

Multimodal Prehabilitation in Patients Undergoing Complex Colorectal Surgery, Liver Resection, and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): A Pilot Study on Feasibility and Potential Efficacy

Dieuwke Strijker et al. Cancers (Basel). .

Abstract

Background: Surgery for complex primary and metastatic colorectal cancer (CRC), such as liver resection and hyperthermic intraperitoneal chemotherapy (HIPEC), in academic settings has led to improved survival but is associated with complications up to 75%. Prehabilitation has been shown to prevent complications in non-academic hospitals. This pilot study aimed to determine the feasibility and potential efficacy of a multimodal prehabilitation program in patients undergoing surgery in an academic hospital for complex primary and metastatic CRC.

Methods: All patients awaiting complex colorectal surgery, liver resection, or HIPEC from July 2019 until January 2020 were considered potentially eligible. Feasibility was measured by accrual rate, completion rate, adherence to the program, satisfaction, and safety. To determine potential efficacy, postoperative outcomes were compared with a historical control group.

Results: Sixteen out of twenty-five eligible patients (64%) commenced prehabilitation, and fourteen patients fully completed the intervention (88%). The adherence rate was 69%, as 11 patients completed >80% of prescribed supervised trainings. No adverse events occurred, and all patients expressed satisfaction with the program. The complication rate was significantly lower in the prehabilitation group (37.5%) than the control group (70.2%, p = 0.020). There was no difference in the type of complications.

Conclusion: This pilot study illustrates that multimodal prehabilitation is feasible in the majority of patients undergoing complex colorectal cancer, liver resection, and HIPEC in an academic setting.

Keywords: colorectal neoplasm MeSH; colorectal surgery MeSH; hyperthermic intraperitoneal chemotherapy; neoplasm metastasis MeSH; perioperative care; postoperative complications MeSH; prehabilitation.

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Conflict of interest statement

Protein supplements were sponsored by FrieslandCampina, Amersfoort, the Netherlands. FrieslandCampina had no role in in the collection, analyses, interpretation of data, in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow chart for inclusion and exclusion.
See this image and copyright information in PMC

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