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Prehabilitation – current role in surgery

Introduction
Prehabilitation concerns preoperative activities aimed in proper preparation to undergo a surgery and improve postoperative recovery. It includes the interdisciplinary approach by presurgical improvement of physical fitness and nourishment status, mental training and quitting addictions. The aim of the study was to investigate the recent publications in the field of prehabilitation.
Methods
We performed a systematic review in the PubMed database using the formula ‘preopreative OR before surgery, postoperative OR after surgery, prehabilitation’. The inclusion criteria were studies with a minimum population of 50 patients, including preoperative interventions, defined with a term prehabilitation, and their impact on a postoperative course of the patient. Three hundred seventy records were revealed and 13 studies were finally included in the analysis.
Results
According to qualified studies, prehabilitation improves significantly postoperative complications rate, length of hospital stay, postoperative physical activity, treatment costs, perioperative transfusions rate, antibiotic administration, and following the postoperative recommendations by patients. On the other hand, there is a lack of statistically significant impact of prehabilitation on quality of life, psychological condition, readmissions, and reoperations.
Discussion
Prehabilitation promotes development of multimodal care putting the patient’s well-being in the centre. Numerous studies indicate positive results of prehabilitation programs. 
The final results depend on the protocol of prehabilitation, selected group of patients and standard of care of the center.
Conclusion
Prehabilitation is necessary for providing the highest quality of care for a surgical patient. Interdisciplinary approach benefit a patient during the operation as well as in the postoperative period. Every surgical clinic should be aware of the idea of prehabilitation and possibly create their own programs.


