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Comment & Response
June 17, 2020

Prehabilitation vs Postoperative Rehabilitation for Frail Patients

Author Affiliations
  • 1Division of Aging, Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Division of Thoracic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA Surg. Published online June 17, 2020. doi:10.1001/jamasurg.2020.1813

To the Editor In the their article in JAMA Surgery, Carli et al1 reported their results of a well-designed and detailed randomized clinical trial on the effect of prehabilitation on postoperative complications in frail patients who underwent resection of colorectal cancer. The study design and interventions were aiming to answer the question to a frequently faced dilemma: whether we can actively improve outcomes of frail older adults undergoing major surgery by increasing their functional and nutritional reserves and therefore having less of a decline and morbidity in the postoperative period. They concluded that in frail patients undergoing predominantly minimally invasive colorectal surgery, a multimodal prehabilitation program was not found to improve postoperative outcomes in the study population. However, there are some points to consider, and the door of prehabilitation in frail older adults who are candidates for major surgery should not be closed yet.

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