Prehabilitation in patients undergoing colorectal surgery fails to confer reduction in overall morbidity : results of a single-center, blinded, randomized controlled trial

Gloor, Severin; Misirlic, Merima; Frei-Lanter, Cornelia; Herzog, Pascal; Müller, Phaedra; Schäfli-Thurnherr, Judit; Lamdark, Tenzin; Schregel, Dorothee; Wyss, Roland; Unger, Ines; Gisi, David; Greco, Nicola; Mungo, Giuseppe; Wirz, Markus; Raptis, Dimitri Aristotle; Tschuor, Christoph; Breitenstein, Stefan

doi:10.1007/s00423-022-02449-0

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Prehabilitation in patients undergoing colorectal surgery fails to confer reduction in overall morbidity : results of a single-center, blinded, randomized controlled trial
Authors:	Gloor, Severin Misirlic, Merima Frei-Lanter, Cornelia Herzog, Pascal Müller, Phaedra Schäfli-Thurnherr, Judit Lamdark, Tenzin Schregel, Dorothee Wyss, Roland Unger, Ines Gisi, David Greco, Nicola Mungo, Giuseppe Wirz, Markus Raptis, Dimitri Aristotle Tschuor, Christoph Breitenstein, Stefan
et. al:	No
DOI:	10.1007/s00423-022-02449-0
Published in:	Langenbecks Archives of Surgery
Volume(Issue):	407
Issue:	3
Page(s):	897
Pages to:	907
Issue Date:	27-Jan-2022
Publisher / Ed. Institution:	Springer
ISSN:	1435-2443 1435-2451
Language:	English
Subjects:	Colorectal; ERAS; Prehabilitation
Subject (DDC):	615.82: Physical therapy 617: Surgery
Abstract:	Background: Currently, there are solely weak recommendations in the enhanced recovery after surgery (ERAS) protocol regarding the role of preoperative physical activity and prehabilitation in patients undergoing colorectal surgery. Studies in heterogenous groups showed contradictory results regarding the impact of prehabilitation on the reduction of postoperative complications. The aim of this study was to assess the impact of prehabilitation on postoperative complications in patients undergoing colorectal surgery within an ERAS protocol. Methods. Between July 2016 and June 2019, a single-center, blinded, randomized controlled trial designed to test whether physiotherapeutic prehabilitation vs. normal physical activities prior to colorectal surgery may decrease morbidity within a stringent ERAS protocol was carried out. The primary endpoint was postoperative complications assessed by Comprehensive Complications Index (CCI®). Primary and secondary endpoints for both groups were analyzed and compared. Results: A total of 107 patients (54 in the prehabilitation enhanced recovery after colorectal surgery [pERACS] group and 53 in the control group) were included in the study and randomized. Dropout rate was 4.5% (n = 5). Baseline characteristics were comparable between the pERACS and control groups. The percentage of colorectal adenocarcinoma was low in both groups (pERACS 32% vs. control 23%, p = 0.384). Almost all patients underwent minimally invasive surgery in both groups (96% vs. 98%, p = 1.000). There was no between-group difference in the primary outcome, as the mean CCI at 30-day postoperative in the pERACS group was 18 (SD 0–43) compared to 15 (SD 0–49) in the control group (p = 0.059). Secondary outcome as complications assessed according to Clavien-Dindo, length of hospital stay, reoperation rate, and mortality showed no difference between both groups. Conclusions: Routine physiotherapeutic prehabilitation has no additional benefit for patients undergoing colorectal surgery within an ERAS protocol. Trial registration: ClinicalTrial.gov: ID: NCT02746731; Institution Ethical Board Approval: KEK-ZH Nr. 2016–00,229.
URI:	https://digitalcollection.zhaw.ch/handle/11475/24487
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Health Sciences
Organisational Unit:	Institute of Physiotherapy (IPT)
Published as part of the ZHAW project:	Präoperative Physiotherapie bei kolorektalen Eingriffen
Appears in collections:	Publikationen Gesundheit

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Gloor, S., Misirlic, M., Frei-Lanter, C., Herzog, P., Müller, P., Schäfli-Thurnherr, J., Lamdark, T., Schregel, D., Wyss, R., Unger, I., Gisi, D., Greco, N., Mungo, G., Wirz, M., Raptis, D. A., Tschuor, C., & Breitenstein, S. (2022). Prehabilitation in patients undergoing colorectal surgery fails to confer reduction in overall morbidity : results of a single-center, blinded, randomized controlled trial. Langenbecks Archives of Surgery, 407(3), 897–907. https://doi.org/10.1007/s00423-022-02449-0

Gloor, S. et al. (2022) ‘Prehabilitation in patients undergoing colorectal surgery fails to confer reduction in overall morbidity : results of a single-center, blinded, randomized controlled trial’, Langenbecks Archives of Surgery, 407(3), pp. 897–907. Available at: https://doi.org/10.1007/s00423-022-02449-0.

S. Gloor et al., “Prehabilitation in patients undergoing colorectal surgery fails to confer reduction in overall morbidity : results of a single-center, blinded, randomized controlled trial,” Langenbecks Archives of Surgery, vol. 407, no. 3, pp. 897–907, Jan. 2022, doi: 10.1007/s00423-022-02449-0.

GLOOR, Severin, Merima MISIRLIC, Cornelia FREI-LANTER, Pascal HERZOG, Phaedra MÜLLER, Judit SCHÄFLI-THURNHERR, Tenzin LAMDARK, Dorothee SCHREGEL, Roland WYSS, Ines UNGER, David GISI, Nicola GRECO, Giuseppe MUNGO, Markus WIRZ, Dimitri Aristotle RAPTIS, Christoph TSCHUOR und Stefan BREITENSTEIN, 2022. Prehabilitation in patients undergoing colorectal surgery fails to confer reduction in overall morbidity : results of a single-center, blinded, randomized controlled trial. Langenbecks Archives of Surgery. 27 Januar 2022. Bd. 407, Nr. 3, S. 897–907. DOI 10.1007/s00423-022-02449-0

Gloor, Severin, Merima Misirlic, Cornelia Frei-Lanter, Pascal Herzog, Phaedra Müller, Judit Schäfli-Thurnherr, Tenzin Lamdark, et al. 2022. “Prehabilitation in Patients Undergoing Colorectal Surgery Fails to Confer Reduction in Overall Morbidity : Results of a Single-Center, Blinded, Randomized Controlled Trial.” Langenbecks Archives of Surgery 407 (3): 897–907. https://doi.org/10.1007/s00423-022-02449-0.

Gloor, Severin, et al. “Prehabilitation in Patients Undergoing Colorectal Surgery Fails to Confer Reduction in Overall Morbidity : Results of a Single-Center, Blinded, Randomized Controlled Trial.” Langenbecks Archives of Surgery, vol. 407, no. 3, Jan. 2022, pp. 897–907, https://doi.org/10.1007/s00423-022-02449-0.