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术前康复——一种针对复杂患者的简单方法:一项关于卵巢癌患者在肿瘤细胞减灭术前进行术前康复的单中心研究结果

Prehabilitation-A Simple Approach for Complex Patients: The Results of a Single-Center Study on Prehabilitation in Patients with Ovarian Cancer Before Cytoreductive Surgery.

作者信息

Zębalski Marcin Adam, Krzywon Aleksandra, Nowosielski Krzysztof

机构信息

Department of Gynecology, Obstetrics and Gynecological Oncology, University Clinical Center of the Medical University of Silesia, 40-752 Katowice, Poland.

Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland.

出版信息

Cancers (Basel). 2024 Dec 1;16(23):4032. doi: 10.3390/cancers16234032.

DOI:10.3390/cancers16234032
PMID:39682218
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11640205/
Abstract

: Prehabilitation is a low-cost, safe procedure with no side effects, and it may have a positive impact on postoperative outcomes. However, it is not widely implemented. Our study aimed to assess the impact of prehabilitation on postoperative outcomes in patients with ovarian cancer within the field of gynecological oncology. : We analyzed 110 patients with ovarian cancer who participated in a prehabilitation program before cytoreductive surgery. Based on the results of a 6-min walk test (6MWT), patients were divided into two groups: Group A (patients who improved their 6MWT results) and Group B (patients who did not improve their 6MWT results). : Patients in Group A demonstrated better postoperative outcomes. The length of hospital stay was significantly shorter in Group A compared to Group B (median 7 [5, 9] vs. 9 [6, 17], = 0.032). Group A also had a lower overall number of complications and also fewer complications, as summarized by the Clavien-Dindo classification, compared to Group B. : Patient adherence to prehabilitation recommendations was adequate. Prehabilitation was associated with improved postoperative outcomes, including shorter hospital stays and fewer complications. These benefits were more pronounced with higher patient compliance with the prehabilitation program and improvements were recorded in preoperative physical capacity.

摘要

术前康复是一种低成本、安全且无副作用的程序,它可能对术后结果产生积极影响。然而,它并未得到广泛实施。我们的研究旨在评估术前康复对妇科肿瘤领域卵巢癌患者术后结果的影响。

我们分析了110例在减瘤手术前参加术前康复计划的卵巢癌患者。根据6分钟步行试验(6MWT)的结果,患者被分为两组:A组(6MWT结果有所改善的患者)和B组(6MWT结果未改善的患者)。

A组患者术后结果更好。与B组相比,A组的住院时间明显更短(中位数7 [5, 9] 天对9 [6, 17] 天,P = 0.032)。根据Clavien-Dindo分类总结,A组的总体并发症数量也更低,并发症也更少。

患者对术前康复建议的依从性良好。术前康复与改善术后结果相关,包括缩短住院时间和减少并发症。随着患者对术前康复计划的依从性提高,这些益处更为明显,并且术前身体能力也有改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1592/11640205/9892ddaef6be/cancers-16-04032-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1592/11640205/9892ddaef6be/cancers-16-04032-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1592/11640205/9892ddaef6be/cancers-16-04032-g001.jpg

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Prehabilitation-A Simple Approach for Complex Patients: The Results of a Single-Center Study on Prehabilitation in Patients with Ovarian Cancer Before Cytoreductive Surgery.术前康复——一种针对复杂患者的简单方法:一项关于卵巢癌患者在肿瘤细胞减灭术前进行术前康复的单中心研究结果
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本文引用的文献

1
Prehabilitation Consultation on Self-Care and Physical Exercise in Patients Diagnosed with Abdominopelvic Cancer: Protocol of the Study.腹盆腔癌症患者自我护理与体育锻炼的术前康复咨询:研究方案
Healthcare (Basel). 2024 Jul 16;12(14):1423. doi: 10.3390/healthcare12141423.
2
Multimodal prehabilitation and postoperative outcomes in upper abdominal surgery: systematic review and meta-analysis.多模态术前康复与上腹部手术后结局:系统评价和荟萃分析。
Sci Rep. 2024 Jul 11;14(1):16012. doi: 10.1038/s41598-024-66633-6.
3
Presurgical mild anemia is a risk factor for severe postoperative complications of rectal cancer surgery: A Japanese nationwide retrospective cohort study.
术前轻度贫血是直肠癌手术严重术后并发症的一个危险因素:一项日本全国性回顾性队列研究。
Ann Gastroenterol Surg. 2024 Jan 10;8(3):471-480. doi: 10.1002/ags3.12770. eCollection 2024 May.
4
The impact of short-term multimodal prehabilitation on functional capacity in patients with gynecologic malignancies during the perioperative period: A prospective study.短期多模态预康复对妇科恶性肿瘤患者围手术期功能能力的影响:一项前瞻性研究。
Eur J Oncol Nurs. 2024 Jun;70:102577. doi: 10.1016/j.ejon.2024.102577. Epub 2024 Mar 21.
5
Prehabilitation: tertiary prevention matters.术前康复:三级预防至关重要。
Br J Surg. 2024 Mar 2;111(3). doi: 10.1093/bjs/znae028.
6
Recommendations on the use of prehabilitation, i.e. comprehensive preparation of the patient for surgery.术前康复治疗的建议,即患者手术前的综合准备。
Pol Przegl Chir. 2023 Sep 15;95(4):62-91. doi: 10.5604/01.3001.0053.8854.
7
The impact of prehabilitation on outcomes in frail and high-risk patients undergoing major abdominal surgery: A systematic review and meta-analysis.预康复对行大腹部手术的虚弱和高危患者结局的影响:系统评价和荟萃分析。
Clin Nutr. 2024 Mar;43(3):629-648. doi: 10.1016/j.clnu.2024.01.020. Epub 2024 Jan 22.
8
Effects of unimodal or multimodal prehabilitation on patients undergoing surgery for esophagogastric cancer: a systematic review and meta-analysis.单一模式或多模式术前康复对行食管胃交界癌手术患者的影响:系统评价和荟萃分析。
Support Care Cancer. 2023 Dec 7;32(1):15. doi: 10.1007/s00520-023-08229-w.
9
Prehabilitation in colorectal cancer surgery improves outcome and reduces hospital costs.结直肠癌手术前康复可改善预后并降低住院费用。
Eur J Surg Oncol. 2024 Jan;50(1):107302. doi: 10.1016/j.ejso.2023.107302. Epub 2023 Nov 28.
10
Cognitive Prehabilitation: How Can We Counter Neurocognitive Frailty?认知康复:我们如何应对神经认知脆弱?
Eur Urol Focus. 2024 Jan;10(1):16-19. doi: 10.1016/j.euf.2023.11.005. Epub 2023 Nov 27.