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 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.

Automated summary

The importance of sarcopenia in surgical patients has been increasingly recognized, with evidence showing its significance as an independent predictor of postoperative complications and outcomes. Prehabilitation, as a concept to optimize health before surgery, has shown promising initial results in improving patient outcomes.