Naukowcy z Wielkiej Brytanii i Szkocji udowodnili, że trwająca 4 tygodnie prehabilitacja może wpłynąć na skrócenie hospitalizacji pacjentów onkologicznych po operacji nawet o 1,8 dnia. „Chirurgia jest jak maraton pod względem stresu i obciążenia dla organizmu. Nie da się przebiec maratonu bez odpowiedniego treningu” – podkreśla dr Chris Gaffney z Lancaster University.
Badania opublikowane zostały w czasopiśmie „Annals of Surgery” i zostały przeprowadzone przez: dr. Joela Lamberta, chirurga w East Lancashire Teaching Hospitals NHS Trust, dr. Lawrence Hayes’a z University of the West of Scotland, dr. Thomasa Keegana i dr. Chrisa Gaffney z Lancaster University oraz dr. Darena Subara z East Lancashire Teaching Hospitals NHS Trust.
Już jeden tydzień prehabilitacji przynosi korzyści
W badaniach udział wzięli pacjenci z nowotworem wątroby, jelita grubego i górnego odcinka przewodu pokarmowego. Pacjentów podzielono na trzy grupy i wdrożono różne rodzaje prehabilitacji:
- multimodalną – obejmowała ćwiczenia, żywienie i wsparcie psychologiczne;
- bimodalną – ćwiczenia i odżywianie/wsparcie psychologiczne;
- unimodalną – same ćwiczenia lub samo odżywianie.
Okres prehabilitacji trwał u wszystkich pacjentów od 1. do 4. tygodni. Badanie wykazało, że już jeden tydzień prehabilitacji może przynieść korzyści pacjentom. Z kolei 4 tygodnie prehabilitacji wpływają na skrócenie pobytu w szpitalu po operacji średnio o 1,8 dnia w porównaniu ze standardową opieką. Dlatego zdaniem naukowców powinna być ona nieodłącznym elementem przedoperacyjnym w celu przyspieszenia powrotu do zdrowia u pacjentów onkologicznych. Zdaniem dr Lamberta prehabilitacja może również wpłynąć na długość życia pacjentów onkologicznych, ponieważ mogą oni szybciej wrócić do leczenia lub podjąć terapię, np. chemioterapię.
Konieczne dalsze badania na temat wpływu prehabilitacji u pacjentów onkologicznych
Jak podkreślają naukowcy, konieczne są jednak dalsze badania, z długoterminową obserwacją pacjentów onkologicznych, u których wdrożono prehabilitację. W tym celu szpital East Lancashire Teaching Hospitals NHS Trust Uniwersytet w Lancaster podjęły współpracę i zainicjowały badanie SPECS, które pozwoli lepiej zrozumieć potencjalne korzyści z prehabilitacji i rzuci światło na zmiany zachodzące w organizmie, które prowadzą do osiągnięcia lepszych wyników w obliczu poważnej operacji nowotworowej. Obecnie trwa rekrutacja pacjentów do badania.
Na czym polega prehabilitacja?
Prehabilitacja jest dziedziną medycyny okołooperacyjnej, która polega na wielokierunkowym przygotowaniu pacjenta do leczenia, a w szczególności do zabiegu chirurgicznego. Celem jest, by operowany jak najszybciej wrócił do zdrowia i sprawności po zabiegu. Prehabilitacja skraca czas rekonwalescencji i pozwala na osiągnięcie dobrych efektów zabiegu, a także nawet dwukrotnie zmniejsza ryzyko wystąpienia powikłań pooperacyjnych.
Prehabilitacja opiera się na czterech kierunkach działań. W jej czasie eliminuje się nałogi pacjenta, wdraża odpowiednie żywienie, ćwiczenia fizyczne i wsparcie psychologa.
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