Prehabilitation in elderly patients scheduled for liver resection and protocol for Recovery Of Surgery in Elderly

Abstract

Ageing population of first world economies pose unique challenges to surgical community. Enhanced recovery after surgery protocols and pathways do not attempt to optimize or enhance physical function of patients by customized program of physical activity. Increasingly, prehabilitation programs (PP) have gained momentum in orthopaedics, urology, colorectal surgery and hepatopancreaticobiliary surgery. Current evidence of PP in various elective surgical procedures have shown improved outcomes with minimal to none drawback or harm. There is emerging evidence of role of PP in elective liver resection. The aim of this paper is to review the basis of PP and share local multidisciplinary team protocol specifically customized to frail and elderly population - Recovery Of Surgery in Elderly.

Keywords

Prehabilitation / liver resection / hepatocellular carcinoma / pre-operative exercise / ageing

References

[1] Ahmed S,Qiao W,Keem LJ.Quality of life in hepatocellular carcinoma patients treated with transarterial chemoembolization..HPB Surg2016;2016:6120143 PMCID:PMC4838811

[2] Boss GR.Age-related physiological changes and their clinical significance..West J Med1981;135:434-40 PMCID:PMC1273316

[3] Cruz-Jentoft AJ,Bauer JM,Cederholm T.Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People..Age Ageing2010;39:412-23 PMCID:PMC2886201

[4] Otsuji H,Ebata T,Sugawara G.Preoperative sarcopenia negatively impacts post-operative outcomes following major hepatectomy with extrahepatic bile duct resection..World J Surg2015;39:1494-500

[5] Hayashi K,Nakajima H,Inoue T.Preoperative 6-minute walk distance accurately predicts post-operative complications after operations for hepato-pancreato-biliary cancer..Surgery2017;161:525-32

[6] Morley JE.Frailty and sarcopenia in elderly..Wien Klin Wochenschr2016;128:439-45

[7] Coudeyre E,Givron P,Revel M.Could preoperative rehabilitation modify post-operative outcomes after total hip and knee arthroplasty? Elaboration of French clinical practice guidelines..Annales de Réadaptation et de Médecine Physique2007;50:189-97

[8] Rooks DS,Bierbaum BE,Rubano J.Effect of preoperative exercise on measures of functional status in men and women undergoing total hip and knee arthroplasty..Arthritis Rheum2006;55:700-8

[9] Oosting E,Dronkers JJ,Dronkers-Landman CM.Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: a pilot randomized controlled trial..Arch Phys Med Rehabil2012;93:610-6

[10] Au D,Lopez P,Awasthi R.Prehabilitation and acute postoperative physical activity in patients undergoing radical prostatectomy: a secondary analysis from an RCT..Sports Med Open2019;5:18 PMCID:PMC6531507

[11] Painter PL,Ray K,Dibble S.A randomized trial of exercise training after renal transplantation..Transplantation2002;74:42-8

[12] Takahashi A,Bostom A.Physical activity in kidney transplant recipients: a review..Am J Kidney Dis2018;72:433-43

[13] Romano G,Montanaro D.Effects of exercise in renal transplant recipients..World J Transplant2012;2:46-50 PMCID:PMC3782234

[14] Mayo NE,Scott S,Kim DJ.Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery..Surgery2011;150:505-14

[15] Gillis C,Bresee L,Gramlich L.Effects of nutritional prehabilitation, with and without exercise, on outcomes of patients who undergo colorectal surgery: a systematic review and meta-analysis..Gastroenterology2018;155:391-410.e4

[16] Cabilan CJ,Munday J.The effectiveness of prehabilitation or preoperative exercise for surgical patients: a systematic review..JBI Database System Rev Implement Rep2015;13:146-87

[17] Rolving N,Christensen FB,Bünger CE.Does a preoperative cognitive-behavioral intervention affect disability, pain behavior, pain, and return to work the first year after lumbar spinal fusion surgery?.Spine2015;40:593-600

[18] Madhavan S,Soong SL,Huey T.Predicting morbidity of liver resection..Langenbecks Arch Surg2018;403:359-69

[19] Tang EL,Junnarkar SP,Low JK.Predictive value of post-operative drain amylase levels for post-operative pancreatic fistula..Ann Hepatobiliary Pancreat Surg2018;22:397-404 PMCID:PMC6295369

[20] Nakajima H,Inoue T,Mizuno Y.Clinical benefit of preoperative exercise and nutritional therapy for patients undergoing hepato-pancreato-biliary surgeries for malignancy..Ann Surg Oncol2019;26:264-72

[21] Seow JG,Shelat VG.Low serum albumin may predict the need for gastric resection in patients with perforated peptic ulcer..Eur J Trauma Emerg Surg2017;43:293-8

[22] Ausania F,Meléndez R,Ouviña R.Prehabilitation in patients undergoing pancreaticoduodenectomy: a randomized controlled trial..Rev Esp Enferm Dig2019;111:603-8

[23] Janssen TL,Langenberg JCM,Wielders D.Multimodal prehabilitation to reduce the incidence of delirium and other adverse events in elderly patients undergoing elective major abdominal surgery: an uncontrolled before-and-after study..PLoS One2019;14:e0218152 PMCID:PMC6564537

[24] Nielsen PR,Dahl B,Tønnesen H.Prehabilitation and early rehabilitation after spinal surgery: randomized clinical trial..Clin Rehabil2010;24:137-48

[25] Wang B,Chow JJL,Low JK.Prehabilitation program improves outcomes of patients undergoing elective liver resection..J Surg Res2020;251:119-25

[26] Dunne DF,Jones RP,Lythgoe DT.Randomized clinical trial of prehabilitation before planned liver resection..Br J Surg2016;103:504-12

[27] Tandon P,Riess K,Al-Judaibi B.Exercise in cirrhosis: Translating evidence and experience to practice..J Hepatol2018;69:1164-77

[28] Locklear CT,Gerber L.Exercise as an intervention for patients with end-stage liver disease: systematic review..Medicine (Baltimore)2018;97:e12774 PMCID:PMC6211898

[29] Wimble K, Jones C. Enhanced recovery after surgery for liver resection surgery. Dig Med Res. 2019;2. Available from: http://dmr.amegroups.com/article/view/5386 [Last accessed on 20 Mar 2020]

[30] Brustia R,Scatton O.Enhanced recovery after liver surgery..J Visc Surg2019;156:127-37

[31] Strong for Surgery. Available from: https://www.facs.org/quality-programs/strong-for-surgery [Last accessed on 20 Mar 2020]

[32] Shelat VG,Low J.Common bile duct exploration in an elderly Asian population..Int Surg2015;100:261-7 PMCID:PMC4337440

[33] Martínez-Cecilia D,Shelat V,Tranchart H.Laparoscopic versus open liver resection for colorectal metastases in elderly and octogenarian patients: a multicenter propensity score based analysis of short- and long-term outcomes..Ann Surg2017;265:1192-200

[34] Anbalakan K,Pandya GJ.Five year experience in management of perforated peptic ulcer and validation of common mortality risk prediction models - are existing models sufficient? A retrospective cohort study..Int J Surg2015;14:38-44

[35] Kiat TTJ,Junnarkar SP,Woon W.Are traditional scoring systems for severity stratification of acute pancreatitis sufficient?.Ann Hepatobiliary Pancreat Surg2018;22:105-15 PMCID:PMC5981140

[36] van der Windt DJ,Dadashzadeh ER,Varley PR.Preoperative risk analysis index for frailty predicts short-term outcomes after hepatopancreatobiliary surgery..HPB (Oxford)2018;20:1181-8

[37] Lim YP,Tan TL.Evaluating the validity of a nutritional screening tool in hospitalized older adults..Ann Acad of Med Singapore2008;37:S5

[38] Poindessous JL,Renaud A,Héron A.Infirmière et diététicienne: une collaboration efficace en service de rééducation [Nurse and dietitian: effective collaboration in rehabilitation]..Rev Infirm2018;67:39-41(in French)

[39] Anastácio LR.Nutrition therapy: integral part of liver transplant care..World J Gastroenterol2016;22:1513-22 PMCID:PMC4721984

[40] Masuda T,Yoshiya S,Morita K.Nutrition support and infections associated with hepatic resection and liver transplantation in patients with chronic liver disease..JPEN J Parenter Enteral Nutr2013;37:318-26

[41] Doherty DT,Rimmer L,Krige A.Hepatic steatosis in patients undergoing resection of colorectal liver metastases: a target for prehabilitation? A narrative review..Surg Oncol2019;30:147-58

[42] Shelat VG, Pandya GJ. Nutritional Support in dysphagia. Available from: https://www.intechopen.com/books/seminars-in-dysphagia/nutritional-support-in-dysphagia [Last accessed on 20 Mar 2020]

[43] Tao KM,Yang LQ,Lu ZJ.Glutamine supplementation for critically ill adults..Cochrane Database Syst Rev2014;2014:CD010050 PMCID:PMC6517119

[44] Carli F.Prehabilitation to enhance peri-operative care..Anesthesiol Clin2015;33:17-33

[45] Guinan EM,Donohoe C,Hussey J.The physiotherapist and the esophageal cancer patient: from prehabilitation to rehabilitation..Dis Esophagus2017;30:1-12

[46] Fortinsky RH,Seltzer GB.The use of functional assessment in understanding home care needs..Med Care1981;19:489-97

[47] Collin C,Davies S.The Barthel ADL Index: a reliability study..Int Disabil Stud1988;10:61-3

[48] Partridge JS,Martin FC,Bell R.Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery..Br J Surg2017;104:679-87

[49] Carli F.Prehabilitation: a new area of integration between geriatricians, anesthesiologists, and exercise therapists..Aging Clin Exp Res2018;30:241-4

[50] Gupta A.Setting up and functioning of a preanaesthetic clinic..Indian J Anaesth2010;54:504-7 PMCID:PMC3016569