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多模态预康复在计划接受大型手术的克罗恩病患者中的应用:一项叙述性综述。

Multimodal Prehabilitation for Patients with Crohn's Disease Scheduled for Major Surgery: A Narrative Review.

机构信息

Department of Health Science, University of Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy.

Multimodal Prehabilitation Center, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla 6, 50135 Florence, Italy.

出版信息

Nutrients. 2024 Jun 6;16(11):1783. doi: 10.3390/nu16111783.


DOI:10.3390/nu16111783
PMID:38892714
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11174506/
Abstract

Approximately 15-50% of patients with Crohn's disease (CD) will require surgery within ten years following the diagnosis. The management of modifiable risk factors before surgery is essential to reduce postoperative complications and to promote a better postoperative recovery. Preoperative malnutrition reduced functional capacity, sarcopenia, immunosuppressive medications, anemia, and psychological distress are frequently present in CD patients. Multimodal prehabilitation consists of nutritional, functional, medical, and psychological interventions implemented before surgery, aiming at optimizing preoperative status and improve postoperative recovery. Currently, studies evaluating the effect of multimodal prehabilitation on postoperative outcomes specifically in CD are lacking. Some studies have investigated the effect of a single prehabilitation intervention, of which nutritional optimization is the most investigated. The aim of this narrative review is to present the physiologic rationale supporting multimodal surgical prehabilitation in CD patients waiting for surgery, and to describe its main components to facilitate their adoption in the preoperative standard of care.

摘要

大约 15-50%的克罗恩病 (CD) 患者在诊断后十年内需要手术。手术前管理可改变的危险因素对于减少术后并发症和促进更好的术后恢复至关重要。术前营养不良、功能能力降低、肌肉减少症、免疫抑制药物、贫血和心理困扰在 CD 患者中经常出现。多模式术前康复包括术前实施的营养、功能、医疗和心理干预,旨在优化术前状态并改善术后恢复。目前,尚无研究评估多模式术前康复对 CD 患者术后结局的影响。一些研究调查了单一术前康复干预的效果,其中营养优化是研究最多的。本综述的目的是阐述支持 CD 患者手术前多模式手术前康复的生理学依据,并描述其主要组成部分,以促进其在术前常规护理中的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6385/11174506/32cc112abf27/nutrients-16-01783-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6385/11174506/b5c0594f19c0/nutrients-16-01783-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6385/11174506/32cc112abf27/nutrients-16-01783-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6385/11174506/b5c0594f19c0/nutrients-16-01783-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6385/11174506/32cc112abf27/nutrients-16-01783-g002.jpg

相似文献

[1]
Multimodal Prehabilitation for Patients with Crohn's Disease Scheduled for Major Surgery: A Narrative Review.

Nutrients. 2024-6-6

[2]
Effect of long-lasting nutritional prehabilitation on postoperative outcome in elective surgery for IBD.

Clin Nutr. 2021-3

[3]
Prehabilitation prior to intestinal resection in Crohn's disease patients: An opinion review.

World J Gastroenterol. 2022-6-14

[4]
Nutritional Prehabilitation in Patients Undergoing Abdominal Surgery-A Narrative Review.

Nutrients. 2024-7-11

[5]
Prehabilitation, enhanced recovery after surgery, or both? A narrative review.

Br J Anaesth. 2022-3

[6]
Effects of preoperative nutrition and multimodal prehabilitation on functional capacity and postoperative complications in surgical lung cancer patients: a systematic review.

Support Care Cancer. 2021-10

[7]
Does preoperative enteral or parenteral nutrition reduce postoperative complications in Crohn's disease patients: a meta-analysis.

Eur J Gastroenterol Hepatol. 2018-9

[8]
Role of prehabilitation following major uro-oncologic surgery: a narrative review.

World J Urol. 2022-6

[9]
Multimodal prehabilitation in colorectal cancer patients to improve functional capacity and reduce postoperative complications: the first international randomized controlled trial for multimodal prehabilitation.

BMC Cancer. 2019-1-22

[10]
Nutritional interventions in prehabilitation for cancer surgery.

Curr Opin Clin Nutr Metab Care. 2023-11-1

引用本文的文献

[1]
ERAS and minimally invasive colorectal surgery: the archetypal non-adherent patients.

Surg Endosc. 2025-8-7

[2]
Preoperative Optimization for Elective Surgery in Crohn's Disease: A Narrative Review.

J Clin Med. 2025-2-26

本文引用的文献

[1]
Well-Being Therapy in systemic sclerosis outpatients: a randomized controlled trial.

Rheumatology (Oxford). 2025-2-1

[2]
Sex-related differences in functional capacity and its implications in risk stratification before major non-cardiac surgery: a analysis of the international METS study.

EClinicalMedicine. 2023-9-28

[3]
Consensus-defined sarcopenia predicts adverse outcomes after elective abdominal surgery: meta-analysis.

BJS Open. 2023-7-10

[4]
Diagnostic Criteria and Prognostic Relevance of Sarcopenia in Patients with Inflammatory Bowel Disease-A Systematic Review.

J Clin Med. 2023-7-16

[5]
Systematic review of sarcopenia in inflammatory bowel disease.

Clin Nutr. 2023-8

[6]
The use of digital technologies to support home-based prehabilitation prior to major surgery: A systematic review.

Surgeon. 2023-12

[7]
Imaging-based assessment of body composition in patients with Crohn's disease: a systematic review.

Int J Colorectal Dis. 2023-5-12

[8]
Exercise Perceptions and Experiences in Adults With Crohn's Disease Following a Combined Impact and Resistance Training Program: A Qualitative Study.

Crohns Colitis 360. 2023-3-24

[9]
Risk assessment for major adverse cardiovascular events after noncardiac surgery using self-reported functional capacity: international prospective cohort study.

Br J Anaesth. 2023-6

[10]
Inflammation and malnutrition in inflammatory bowel disease.

Lancet Gastroenterol Hepatol. 2023-6

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