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01-12-2021 | COVID-19 | Original Article

Effect of home-based prehabilitation in an enhanced recovery after surgery program for patients undergoing colorectal cancer surgery during the COVID-19 pandemic

Authors: Francisco López-Rodríguez-Arias, Luis Sánchez-Guillén, Verónica Aranaz-Ostáriz, Daniel Triguero-Cánovas, Sandra Lario-Pérez, Xavier Barber-Valles, Francisco J. Lacueva, José M. Ramirez, Antonio Arroyo

Published in: Supportive Care in Cancer | Issue 12/2021

Abstract

Background

Surgery remains the first curative treatment for colorectal cancer. Prehabilitation seems to attenuate the loss of lean mass in the early postoperative period. However, its long-term role has not been studied. Lockdown due to the COVID-19 pandemic has forced to carry out the prehabilitation program at home. This study aimed to assess the effect of home prehabilitation on body composition, complications, and hospital stay in patients undergoing oncological colorectal surgery.

Methods

A prospective and randomized clinical study was conducted in 20 patients operated of colorectal cancer during COVID-19 lockdown (13 March to 21 June 2020) in a single university clinical hospital. Patients were randomized into two study groups (10 per group): prehabilitation vs standard care. Changes in lean mass and fat mass at 45 and 90 days after surgery were measured using multifrequency bioelectrical impedance analysis.

Results

Prehabilitation managed to reduce hospital stay (4.8 vs 7.2 days, p = 0.052) and postoperative complications (20% vs 50%, p = 0.16). Forty-five days after surgery, the loss of lean mass decreased (1.7% vs 7.1%, p = 0.17). These differences in lean mass were attenuated at 90 days; however, the standard care group increased considerably their fat mass compared to the prehabilitation group (+ 8.72% vs − 8.16%).

Conclusions

Home prehabilitation has proven its effectiveness, achieving an attenuation of lean mass loss in the early postoperative period and a lower gain in fat mass in the late postoperative period. In addition, it has managed to reduce hospital stays and postoperative complications.

Registration number

This article is part of an ongoing, randomized, and controlled clinical trial approved by the ethics committee of our hospital and registered in ClinicalTrials.gov in August 2018 with registration number NCT03618329.

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Title: Effect of home-based prehabilitation in an enhanced recovery after surgery program for patients undergoing colorectal cancer surgery during the COVID-19 pandemic
Authors: Francisco López-Rodríguez-Arias
Luis Sánchez-Guillén
Verónica Aranaz-Ostáriz
Daniel Triguero-Cánovas
Sandra Lario-Pérez
Xavier Barber-Valles
Francisco J. Lacueva
José M. Ramirez
Antonio Arroyo
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: COVID-19
Colorectal Cancer
Colorectal Cancer
Published in: Supportive Care in Cancer / Issue 12/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-021-06343-1

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Abstract

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