Prehabilitation Before Esophagectomy: What Are the Benefits of Exercise?

Exercise prehabilitation programs are increasingly being incorporated in usual care pathways for patients with esophageal cancer, aimed to enhance a patients’ functional capacity prior to surgery and to improve postoperative outcomes. In the literature there is moderate evidence that exercise prehabilitation reduces the risk of postoperative pulmonary complications and weak evidence that it improves quality of life after esophagectomy. The current literature does not provide enough evidence regarding the effectiveness of exercise prehabilitation on decreasing overall postoperative complications or hospital length of stay. Evidence concerning its effects on functional recovery is lacking. Also, there is no evidence to support implementation of preoperative inspiratory muscle training as a stand-alone intervention to improve postoperative recovery. Exercise prehabilitation may have the potential to promote a patients’ recovery after surgery. However, future studies are required in high-risk surgical patients with the focus on functional- and recovery-related outcome measures.