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Inicio Cirugía Española (English Edition) 10 years of prehabilitation: From theory to clinical practice
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Special article
Pre-proof, online 7 May 2024
10 years of prehabilitation: From theory to clinical practice
10 años prehabilitando: De la teoría a la práctica clínica
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Marta Ubréa,
Corresponding author
mubre@clinic.cat

Corresponding author.
, M. Montané-Muntanéa, I. Diégueza, G. Martínez-Pallía,b,c
a Department of Anesthesiology, Hospital Clínic de Barcelona, Barcelona, Spain
b Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
c Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain
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Abstract

In recent years, prehabilitation has generated high expectations as an innovative preoperative strategy to enhance clinical outcomes following surgery. Several studies have demonstrated that multimodal programs are effective in improving patients’ health status and cardiopulmonary reserve, allowing them to undergo surgery in better conditions and, consequently, reducing the incidence of postoperative complications.

Most publications describe proof-of-concept studies, and literature about their implementation is more limited. The implementation of these programs requires new resources and significant organizational effort.

In this paper, we share our experience implementing a multimodal prehabilitation program as a mainstream service at a tertiary hospital. Although there are still many unknowns regarding the optimal selection of patients, as well as the duration and components of the program, this article describes our journey in this field, aiming to provide insight for teams interested in developing a similar project.

Keywords:
prehabilitation
major surgery
preoperative optimization
postoperative complications
implementation
Resumen

En los últimos años, la prehabilitación ha generado grandes expectativas como estrategia preoperatoria para mejorar los resultados clínicos tras una cirugía. Diversos estudios demuestran su eficacia para mejorar el estado de salud y la reserva cardiorrespiratoria del paciente para hacer frente a la cirugía en mejores condiciones y, por tanto, disminuir las complicaciones postoperatorias.

La mayoría de publicaciones describen estudios de eficacia preliminares, siendo la literatura sobre su implementación más limitada. La incorporación de estos programas requiere de recursos adicionales y de un gran esfuerzo organizativo.

Este artículo recoge nuestra experiencia en la puesta en marcha de un programa de prehabilitación multimodal en un hospital terciario. Aunque quedan todavía muchas incógnitas sobre la selección óptima de pacientes, y la duración y componentes del programa, el artículo describe nuestra trayectoria con el objetivo de poder ayudar a aquellos grupos que quieran llevar a cabo un programa de prehabilitación.

Palabras clave:
Prehabilitación
cirugía mayor
optimización preoperatoria
complicaciones postoperatorias
implementación

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