Scholarlink

<p>Surgical procedures represent a&#xa0;considerable physical and psychological burden for patients. This is particularly true for complex visceral surgery, which is associated with a&#xa0;markedly higher perioperative risk. The concept of prehabilitation aims to strengthen patients during the preoperative phase through targeted interventions such as physical exercise, nutritional optimization, and hematological management. In this way, functional reserves can be enhanced, the postoperative recovery process structured, and convalescence facilitated. Randomized controlled trials and meta-analyses provide a&#xa0;consistent evidence-based foundation showing that intensified prehabilitation programs can reduce postoperative morbidity and length of hospital stay. However, the beneficial effect is not equally pronounced in all patients: whereas physically very fit individuals appear to derive limited additional benefit, patients with impaired general condition, such as reduced functional capacity, malnutrition, or anemia, experience significant advantages. This highlights the importance of careful patient selection and raises the question of optimal timing. Moreover, prehabilitation benefits not only cancer but also non-cancer patients, thereby offering advantages for a&#xa0;broad patient population. Current evidence indicates that a&#xa0;preoperative prehabilitation period of approximately 4&#xa0;weeks is generally feasible without exerting a&#xa0;negative impact on oncological outcomes. Despite the overall promising data, the quality of evidence in meta-analyses continues to be regarded as limited in terms of validity and to be of only moderate explanatory power, largely due to the considerable methodological and content-related heterogeneity of the included studies. This heterogeneity concerns not only patient populations, interventions, and endpoints, but also the highly variable compliance observed. This may also explain why the implementation of prehabilitation concepts in Germany has thus far progressed only slowly. In particular, the absence of clear reimbursement models, limited personnel and infrastructural resources, and a&#xa0;lack of structural incentives represent major barriers.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Gezielter Einsatz von Prähabilitation : Zielgruppe und Zeitpunkt

  • 期刊论文

  • 发表日期：

    2026年1月6日

查看全文
  • Mahmoud Halawa,
  • Mohamed El-Ahmar,
  • Marc Martignoni,
  • Christoph Reißfelder

摘要

Surgical procedures represent a considerable physical and psychological burden for patients. This is particularly true for complex visceral surgery, which is associated with a markedly higher perioperative risk. The concept of prehabilitation aims to strengthen patients during the preoperative phase through targeted interventions such as physical exercise, nutritional optimization, and hematological management. In this way, functional reserves can be enhanced, the postoperative recovery process structured, and convalescence facilitated. Randomized controlled trials and meta-analyses provide a consistent evidence-based foundation showing that intensified prehabilitation programs can reduce postoperative morbidity and length of hospital stay. However, the beneficial effect is not equally pronounced in all patients: whereas physically very fit individuals appear to derive limited additional benefit, patients with impaired general condition, such as reduced functional capacity, malnutrition, or anemia, experience significant advantages. This highlights the importance of careful patient selection and raises the question of optimal timing. Moreover, prehabilitation benefits not only cancer but also non-cancer patients, thereby offering advantages for a broad patient population. Current evidence indicates that a preoperative prehabilitation period of approximately 4 weeks is generally feasible without exerting a negative impact on oncological outcomes. Despite the overall promising data, the quality of evidence in meta-analyses continues to be regarded as limited in terms of validity and to be of only moderate explanatory power, largely due to the considerable methodological and content-related heterogeneity of the included studies. This heterogeneity concerns not only patient populations, interventions, and endpoints, but also the highly variable compliance observed. This may also explain why the implementation of prehabilitation concepts in Germany has thus far progressed only slowly. In particular, the absence of clear reimbursement models, limited personnel and infrastructural resources, and a lack of structural incentives represent major barriers.