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Published online: 2024-11-05

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Prehabilitation approaches for gastrointestinal cancer surgery: a narrative review

Sergii Girnyi1, Luigi Marano21, Jaroslaw Skokowski21, Piotr Mocarski1, Witold Kycler3, Gaetano Gallo4, Agnieszka Dyzmann-Sroka5, Karolina Kazmierczak-Siedlecka6, Leszek Kalinowski67, Tomasz Banasiewicz8, Karol Polom23

Abstract

Gastrointestinal (GI) cancer patients undergoing surgery are particularly vulnerable to malnutrition, which can significantly impact surgical outcomes. Prehabilitation interventions encompassing nutritional, physical, and psychosocial support have gained attention for their potential to mitigate these risks. However, the efficacy of multidisciplinary prehabilitation programs in this context remains underexplored. This narrative review synthesizes existing literature to evaluate the effectiveness of prehabilitation interventions in improving outcomes for GI cancer patients undergoing surgery. Drawing on a comprehensive analysis of available evidence, the review examines the integration of nutritional, physical, and psychosocial interventions and explores the implications for clinical practice and future research. The review highlights the importance of standardized protocols and interdisciplinary collaboration in optimizing prehabilitation programs for GI cancer patients. It identifies gaps in current research, particularly regarding the synergistic effects of integrating various intervention modalities and the role of innovative strategies such as immunonutrition. Moreover, the review underscores the need for larger studies to assess the effectiveness of multimodal prehabilitation approaches and establish standardized outcome measures.

In conclusion, despite advancements in understanding the importance of prehabilitation, significant gaps persist in the literature, warranting further research to refine prehabilitation protocols and improve perioperative outcomes for GI cancer patients. By addressing these research gaps and fostering interdisciplinary partnerships, future studies have the potential to enhance the effectiveness of prehabilitation interventions and optimize perioperative care in this population.

Keywords: prehabilitationgastrointestinal cancersurgerynutritional interventionmultimodal carefrailty

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