Multimodal prerehabilitation for elderly patients with sarcopenia in colorectal surgery
Jingting Wu, Hannah Chi, Shawn Kok, Jason M.W. Chua, Xi-Xiao Huang, Shipin Zhang, Shi‐Min Mah, Li-Xin Foo, Hui-Yee Peh, Hui-Bing Lee, Phoebe Wen Lin Tay, Cherie Tong, Jasmine Ladlad, Cheryl H.M. Tan, Nathanelle Khoo, Darius Kang Lie Aw, Cheryl Xi Zi Chong, Leonard M. L. Ho, Sharmini Su Sivarajah, Jia Lin Ng, Winson Jianhong Tan, Fung Joon Foo, Bin Tean Teh, Frederick H. Koh
Abstract
Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.