PMID- 36245070
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221214
IS  - 2508-5859 (Electronic)
IS  - 2508-5778 (Print)
IS  - 2508-5859 (Linking)
VI  - 26
IP  - 4
DP  - 2022 Nov 30
TI  - Outcomes of an outpatient home-based prehabilitation program before 
      pancreaticoduodenectomy: A retrospective cohort study.
PG  - 375-385
LID - 10.14701/ahbps.22-028 [doi]
AB  - BACKGROUNDS/AIMS: Prehabilitation aims for preoperative optimisation to reduce 
      postoperative complications. However, there is a paucity of data on its use in 
      patients undergoing pancreaticoduodenectomy (PD). Thus, this study aims to 
      evaluate the outcomes of a home-based outpatient prehabilitation program (PP) 
      versus no-PP in patients undergoing PD. METHODS: This retrospective cohort study 
      compared patients who underwent PP versus no-PP before elective PD from January 
      2016 to December 2020. Inclusion criteria for PP were < 65 years or 65-74 years 
      with FRAIL score < 3. No-PP included dietician, case manager and anesthesia 
      review. PP included additional physiotherapy sessions, caregiver training and 
      interim phone consultation. Univariate and multivariate analysis were used to 
      evaluate length of stay (LOS), morbidity, 30-day readmission, and 90-day 
      mortality. RESULTS: Seventy-one patients (PP: n = 50 [70.4%]; no-PP: n = 21 
      [29.6%]) were included in this study. Median age was 65 years (interquartile 
      range [IQR]: 58-72 years). Majority (n = 58 [81.7%]) of patients underwent open 
      surgery. Ductal adenocarcinoma was the most common histology (49.3%). Patient 
      demographics were comparable between both groups. Overall median LOS was 11.0 
      days (IQR: 8.0-17.0 days). Compared to no-PP, PP was not independently associated 
      with reduced intra-abdominal collections (odds ratio [OR]: 0.43; 95% confidence 
      interval [CI]: 0.03-6.11, p = 0.532), major morbidity (OR: 1.31; 95% CI: 
      0.09-19.47; p = 0.845) or 30-day readmission (OR: 3.16; 95% CI: 0.26-38.27; p = 
      0.365). There was one (1.4%) 30-day mortality. CONCLUSIONS: Our outpatient PP 
      with unsupervised exercise regimes did not improve postoperative outcomes 
      following elective PD.
FAU - Chan, Kai Siang
AU  - Chan KS
AUID- ORCID: 0000-0001-9533-801X
AD  - Department of General Surgery, Tan Tock Seng Hospital, Singapore.
FAU - Junnarkar, Sameer Padmakumar
AU  - Junnarkar SP
AUID- ORCID: 0000-0003-0588-1014
AD  - Department of General Surgery, Tan Tock Seng Hospital, Singapore.
FAU - Wang, Bei
AU  - Wang B
AUID- ORCID: 0000-0001-9336-4505
AD  - Department of General Surgery, Tan Tock Seng Hospital, Singapore.
FAU - Tan, Yen Pin
AU  - Tan YP
AUID- ORCID: 0000-0003-3940-2130
AD  - Department of General Surgery, Tan Tock Seng Hospital, Singapore.
FAU - Low, Jee Keem
AU  - Low JK
AUID- ORCID: 0000-0002-8641-5770
AD  - Department of General Surgery, Tan Tock Seng Hospital, Singapore.
FAU - Huey, Cheong Wei Terence
AU  - Huey CWT
AUID- ORCID: 0000-0001-8575-5645
AD  - Department of General Surgery, Tan Tock Seng Hospital, Singapore.
FAU - Shelat, Vishalkumar Girishchandra
AU  - Shelat VG
AUID- ORCID: 0000-0003-3988-8142
AD  - Department of General Surgery, Tan Tock Seng Hospital, Singapore.
AD  - Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
LA  - eng
PT  - Journal Article
DEP - 20221017
PL  - Korea (South)
TA  - Ann Hepatobiliary Pancreat Surg
JT  - Annals of hepato-biliary-pancreatic surgery
JID - 101698342
PMC - PMC9721255
OTO - NOTNLM
OT  - Enhanced recovery after surgery
OT  - Pancreatic neoplasms
OT  - Pancreaticoduodenectomy
OT  - Preoperative care
OT  - Preoperative exercise
COIS- CONFLICT OF INTEREST No potential conflict of interest relevant to this article 
      was reported.
EDAT- 2022/10/17 06:00
MHDA- 2022/10/17 06:01
PMCR- 2022/10/17
CRDT- 2022/10/16 23:22
PHST- 2022/05/16 00:00 [received]
PHST- 2022/07/27 00:00 [revised]
PHST- 2022/08/01 00:00 [accepted]
PHST- 2022/10/17 06:00 [pubmed]
PHST- 2022/10/17 06:01 [medline]
PHST- 2022/10/16 23:22 [entrez]
PHST- 2022/10/17 00:00 [pmc-release]
AID - ahbps.22-028 [pii]
AID - ahbps-26-4-375 [pii]
AID - 10.14701/ahbps.22-028 [doi]
PST - ppublish
SO  - Ann Hepatobiliary Pancreat Surg. 2022 Nov 30;26(4):375-385. doi: 
      10.14701/ahbps.22-028. Epub 2022 Oct 17.