Personalising prehabilitation: are super surgery schools the future?

Abstract

Prehabilitation is a multimodal intervention delivered before surgery, designed to optimise functional capacity and physiological reserve thereby improving surgical outcomes. Gillis and colleagues report a pragmatic, single-centre hybrid efficiency-implementation feasibility trial for a group-based, personalised prehabilitation class integrated into routine care for patients undergoing colorectal surgery. The study reported improvements in postoperative functional recovery, but not in length of stay which was the primary outcome. As in many prehabilitation trials, the study population was skewed towards low-risk, motivated individuals which can limit its generalisability. Furthermore patients felt they required more support to adhere to the programme. Prehabilitation is a complex intervention that needs further evaluation: we highlight some of the challenges that impact implementation.