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Prehabilitation prior to intestinal resection in Crohn’s disease patients: An opinion review

Bak, Michiel T J ; Ruiterkamp, Marit F E ; van Ruler, Oddeke ; Campmans-Kuijpers, Marjo J E ; Bongers, Bart C ; van Meeteren, Nico L U ; van der Woude, C Janneke ; Stassen, Laurents P S ; de Vries, Annemarie C

World journal of gastroenterology : WJG, 2022-06, Vol.28 (22), p.2403-2416

Baishideng Publishing Group Inc

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  • Título:
    Prehabilitation prior to intestinal resection in Crohn’s disease patients: An opinion review
  • Autor: Bak, Michiel T J ; Ruiterkamp, Marit F E ; van Ruler, Oddeke ; Campmans-Kuijpers, Marjo J E ; Bongers, Bart C ; van Meeteren, Nico L U ; van der Woude, C Janneke ; Stassen, Laurents P S ; de Vries, Annemarie C
  • Assuntos: Review
  • É parte de: World journal of gastroenterology : WJG, 2022-06, Vol.28 (22), p.2403-2416
  • Notas: Author contributions: Bak MTJ reviewed and summarized the literature, and drafted the article; Ruiterkamp MFE reviewed the literature; de Vries AC supervised the study; and all authors contributed substantially to the concept and design of the study, critically revised the article, and approved the final version.
    Corresponding author: Annemarie C de Vries, MD, PhD, Doctor, Staff Physician, Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 40, Rotterdam 3015 GD, Netherlands. a.c.devries@erasmusmc.nl
  • Descrição: Patients with Crohn’s disease (CD) are at a considerable risk for intestinal surgery. Approximately 25% of patients with CD will undergo an intestinal resection within 10 years of diagnosis. Postoperative complications after CD surgery have been reported in 20%-47% of the patients. Both general and CD-related risk factors are associated with postoperative complications, and comprise non-modifiable ( e.g., age) and potentially modifiable risk factors ( e.g., malnutrition). Prehabilitation focuses on the preoperative period with strategies designed to optimize modifiable risk factors concerning the physical and mental condition of the individual patient. The aim of prehabilitation is to enhance postoperative recovery and return to or even improve preoperative functional capacity. Preoperative improvement of nutritional status, physical fitness, cessation of smoking, psychological support, and critical revision of preoperative use of CD medication are important strategies. Studies of the effect on postoperative outcome in CD patients are scarce, and guidelines lack recommendations on tailored management. In this opinion review, we review the current evidence on the impact of screening and management of nutritional status, physical fitness, CD medication and laboratory values on the postoperative course following an intestinal resection in CD patients. In addition, we aim to provide guidance for individualized multimodal prehabilitation in clinical practice concerning these modifiable factors.
  • Editor: Baishideng Publishing Group Inc
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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