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

Overview

Journal Nutrients

Date 2024 Jun 19

PMID 38892714

Authors

Camilla Fiorindi

Francesco Giudici

Giuseppe Dario Testa

Lorenzo Foti

Sara Romanazzo

Cristina Tognozzi

Giovanni Mansueto

Stefano Scaringi

Francesca Cuffaro

Anita Nannoni

Mattias Soop

Gabriele Baldini

Affiliations

Soon will be listed here.

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.

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