Prehabilitation to enhance postoperative recovery for an octogenarian following robotic-assisted hysterectomy with endometrial cancer View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2012-08

AUTHORS

Franco Carli, Russell Brown, Stephan Kennepohl

ABSTRACT

PURPOSE: Postoperative complications represent a major concern for elderly patients. We report a case of a medically complex and frail 88-yr-old woman with endometrial cancer who was scheduled for a robotic-assisted total abdominal hysterectomy. In addition to her cardiac morbidity she presented with several risk factors for neurocognitive decline, including prior episodes of postoperative delirium. CLINICAL FEATURES: The patient underwent functional, nutritional, and neuropsychological assessments prior to a three-week prehabilitation home-based program consisting of strength and endurance exercises as well as nutritional optimization. Remarkably, there were no episodes of postoperative confusion, and over the following eight weeks, she continued to show sustained improvement in exercise tolerance (as per the six-minute walk test), cognitive function (as per the Repeatable Battery for the Assessment of Neuropsychological Status), and overall functional capacity (Short Form-36). CONCLUSION: This report provides suggestive evidence that a prehabilitation program optimized the health of this elderly patient and may have prevented a further episode of postoperative delirium. Prehabilitation protocols should be evaluated in clinical trials to evaluate their efficacy and the target populations who may benefit and to elucidate the underlying mechanisms responsible for enhanced recovery in the perioperative setting. More... »

PAGES

779-784

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12630-012-9734-4

DOI

http://dx.doi.org/10.1007/s12630-012-9734-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1049065043

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22638674


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