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J Thorac Dis. 2019 Apr;11(Suppl 5):S632-S638. doi: 10.21037/jtd.2019.02.12.

Prehabilitation for esophagectomy.

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Department of Surgery and Cancer, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.


Esophagectomy remains the mainstay treatment of esophageal cancer (EC). Combined with neoadjuvant therapies, the management of EC has deleterious effects on body composition, functional capacity and psychological well-being. Preoperative patient optimisation known as prehabilitation is a novel intervention aimed at reducing morbidity and mortality associated with the trajectory of EC care. There is emerging evidence to suggest that prehabilitation is safe, feasible and efficacious. In addition, there is strong data to infer that prehabilitation has a positive effect on functional capacity through exercise. Nutritional and psychological interventions are less well evaluated. Furthermore, no convincing relationship between prehabilitation and oncological outcomes has been demonstrated. Early studies evaluating prehabilitation are promising however further large scale research is required in order to assess the clinical effectiveness.


Prehabilitation; exercise; nutrition; preoperative optimization

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Conflicts of Interest: The authors have no conflicts of interest to declare.

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