La « préhabilitation » : ce que le chirurgien doit savoir

Despite advances in surgical techniques, anesthesia and perioperative care, which became safer and accessible to a higher proportion of high-risk patients, major surgery remains morbid with a lot of patients not recovering their previous capacity. Indeed, surgery is a physiological stress and decreases functional capacity in the postoperative period. A “prehabilitation” program should increase functional capacity in anticipation of an upcoming stress. It should occur after the surgical consultation and before surgery, and is based on three components: (1) physical care; (2) nutritional support; and (3) psychological support, during 6 to 8 weeks. The aims of prehabilitation are to improve both nutritional status and pre- and postoperative fitness, and to reduce postoperative complications. Prehabilitation demonstrated benefit on postoperative complications in cardiovascular surgery but its benefit in digestive surgery is still unclear with contradictory results. The aim of this review was to summarize results of prehabilitation on the pre- and postoperative period and to determine its possible future in digestive surgery.