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Abstract
Introduction/Background ERAS pathways aim to standardise and optimise perioperative care and modulate postoperative metabolic and inflammatory response linked with adverse outcomes after surgery. ERAS protocol shown to decrease complications, length of hospital stay and costs but several challenges deserve further discussion.
First phase of ERAS protocol is the Pre Habilitation defined as ’a process on the continuum of care that occurs between the time of cancer diagnosis and the beginning of acute treatment’.
Prehabilitation aims to optimize patients’ physical and mental well-being. There is currently no consensus-based definition, but a multimodal approach that encompasses aerobic and resistance exercises to improve physical function, dietary interventions and psychological interventions seems to be the most correct one.
Some gynecologic prehabilitation studies are ongoing worldwide but results are not yet available.
Data in colorectal surgery shows patients‘ clinical benefit from prehabilitation.
Methodology PRE HAB GYN is a multidisciplinary, prospective, non-profit, single-center pilot study at Obstetric and Gynecology Division at Ferrero Ospital in Verduno (Italy).
The aim is to ascertain the ability of the pre-habilitation protocol to increase the performance of the patients in the pre-operative phase and consequently in the post-operative phase.
Primary end point of the study is aerobic fitness improvement (6-minute walking test).
Secondary endpoints are: lifestyle modification, postoperative morbidity, adverse events, length of hospital stay, malnutrition and sarcopenia assessment, lean mass stability, QoL, psychological and sexual health.
Results Until now we have enrolled 16 patients (2 affected by cervical cancers and 14 endometrial cancers).
Our preliminary subjective results show good acceptance of the trial (71%) and no cases of discontinuation of the protocol.
85% of the patients loss weight (almost 6% of the starting weight)
Conclusion With limits of these preliminary evaluation and small number of cases we can suggest that the protocol is faisable, well accepted and functional for patients affected by gynecological cancers.
Disclosures No.
