Preoperative prehabilitation in patients with colorectal cancer leads to a faster recovery and a strong reduction in serious complications. This is evident from the results of the so-called PREHAB trial, which was carried out in 5 countries, including the Netherlands. It is expected that prehabilitation will soon be available to all surgical patients in the Netherlands.
prehabilitation program
Where previously the main focus was on how to limit complications during and after surgery, there has recently been increasing attention to prehabilitation.Prehabilitation is a program in which patients are supported to go into surgery fit. The 4-week prehabilitation program from the PREHAB trial consists of 5 pillars: training for strength and condition, dietary advice with extra proteins and vitamins, lifestyle (including quitting smoking), mental guidance and correction of anaemia. The PREHAB trial included 270 colorectal cancer patients from Canada, Spain, Denmark, Italy and the Netherlands. They were participating Dutch hospitals Máxima MC (MMC) in Veldhoven and the Amphia in Breda. A program was tailor-made for each participant for maximum effect.
Fewer complications and faster recovery
The results show that patients who followed the prehabilitation program had 40 percent fewer serious complications compared to patients who did not participate in the program. This is an important gain because complications can stand in the way of a full recovery. According to Gerrit Slooter, researcher and oncological surgeon in MMC, the gain is based on several factors: ‘Patients are more involved both before and after surgery. Due to the increased strength and condition, patients have confidence to actively work on their recovery the day after the operation.’ Slooter also sees that patients from MMC who have prehabilitated can go home with discharge on average 2 days earlier.
Savings of 60 million euros
The results from the PREHAB trial confirm that prehabilitation is effective. The Federation of Medical Specialists (FMS) and the Dutch Society for Surgery (NVvH) have calculated that the use of prehabilitation alone in operations for cancer of the colon may save 60 million euros in 5 years. Because there is no structural financing for prehabilitation, it is very difficult for hospitals to fit the costs into the budget. That is why MMC, together with UMC Groningen, Radboudumc and Reinier de Graaf Gasthuis, is united in the Prehabilitation working group of the NVvH and the Fit4Surgery Foundation. As a working group they collect evidence on the effectiveness of the prehabilitation programme. In addition, a “Prehabilitation Standpoint” has been drawn up, a national protocol that can ensure that prehabilitation is universally offered by all hospitals.
Source: Maxima MC
