The impact of trimodal prehabilitation strategy on functional capability and short-term quality of life for patients undergoing laparoscopic partial hepatectomy
LIU Huimin, YAN Yimin, FENG Bin, ZHENG Mingzhi, REN Fangyuan
The Affiliated Zhuzhou Hospital of Xiangya Medical College, Central South University, Zhuzhou 412007, China
Abstract：Objective To investigate the impact of trimodal prehabilitation strategy on perioperative functional capability and short-term quality of life for patients undergoing laparoscopic partial hepatectomy. Methods 100 cases of patients undergoing elective laparoscopic partial hepatectomy in our hospital from April 2022 to November 2023 were randomly divided into control group and prehabilitation group, each were 50 cases. The control group received conventional preparation for laparoscopic surgery, while the prehabilitation group received trimodal prehabilitation intervention strategy before surgery, about 2-4 weeks. All patients were followed up 30 days after discharge. The perioperative (at the baseline, 1 day before surgery, 7 days after surgery and 30 days after surgery) functional capability included: the validated six-minute walking distance (6MWD) was used to evaluate motor function, the hospital anxiety and depression scale (HADS) was used to evaluate the psychological status, and the nutritional indicators of prealbumin, albumin and total protein was used to evaluate the nutritional status. Short-term quality of life measured using SF-36 Health Survey Form (SF-36). The operation time, intraoperative blood loss, hospitalization time, abdominal drainage, postoperative complications and readmission within 30 days after discharge of two groups were compared. Results The operation time and intraoperative blood loss of two groups had no significant difference. Prehabilitation group had a significant reduction in abdominal drainage on the first day after surgery than control group. The hospitalization time of prehabilitation group was shorted than control group. At baseline, there was no statistically difference in 6MWD, HADS anxiety score, HADS depression score, prealbumin, albumin, total protein and SF-36 score between two groups.1 day before surgery, 7 days after surgery and 30 days after surgery, 6MWD, prealbumin, albumin and total protein of prehabilitation group were higher than control group.1 day before surgery and 7 days after surgery, HADS anxiety score, HADS depression score of prehabilitation group were decreased compared with the baseline and better than control group.30 days after surgery, HADS anxiety score and HADS depression score of two groups had no significant difference.30 days after surgery, the scores of BP, GH, MH, PF, RP, SF and VT in SF-36 of prehabilitation group were higher than control group. However, there was no significant difference in RE score. The incidence of postoperative complications of prehabilitation group were less than that in control group. There was no case of readmission within 30 days after discharge in both group. Conclusion Trimodal prehabilitation strategy can effectively improve the perioperative functional capability and short-term quality of life for patients undergoing laparoscopic partial hepatectomy. It can improve clinical outcomes and enhanced recovery after surgery.
2024, Vol. 21 
