Objective

The growing recognition of prehabilitation has caused an emerging paradigm shift in surgical cancer care and an integrated component of the cancer care continuum. This narrative review aims to update and inform the urological community of the potential of prehabilitation before radical cystectomy.

Data Sources

A nonsystematic narrative review was performed through a database search in PubMed, and CINAHL using the following search terms: enhanced recovery after surgery (ERAS); Frailty; Prehabilitation and/or Rehabilitation; Physical Activity and/or exercises; Nutrition; Nutritional Care; Smoking cessation; Alcohol cessation; Prevention; Supportive Care; and combined with Radical Cystectomy.

Conclusion

A multimodal and multi-professional approach during the preoperative period may offer an opportunity to preserve or enhance physiological integrity and optimize surgical recovery. Studies indicate a positive effect of prehabilitation on postoperative functional capacity and earlier return to daily activities and health related quality of life. Meaningful outcomes that reflect recovery from a patient's perspective and clinical outcome measures, as well as validating metrics, are necessary to establish whether prehabilitation diminish the risk of developing long-term disability in high-risk patients.

Implications for Nursing Practice

Uro-oncology nurses are at the forefront in every ERAS program and vital in screening patients ahead of surgery for common risk factors, current impairments, and limitations that can compromise baseline functional capacity. The growing movement to standardize clinical implementation of prehabilitation, indicate there is a clear need for further investigation, optimization of a multimodal approach and an open discussion between health care providers from different areas of expertise who might best support and promote these initiatives.

中文翻译：

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根治性膀胱切除术途径中的康复潜力：我们现在在哪里？

客观的

对康复治疗的日益认识已经导致外科癌症护理的新范式转变和癌症护理连续体的一个综合组成部分。这篇叙述性综述旨在更新和告知泌尿外科界关于根治性膀胱切除术前康复治疗的潜力。

数据源

使用以下搜索词通过 PubMed 和 CINAHL 中的数据库搜索进行了非系统性叙述审查：手术后恢复期 (ERAS)；虚弱；康复和/或康复；体育活动和/或锻炼；营养; 营养保健；戒烟; 戒酒；预防; 支持性护理；并结合根治性膀胱切除术。

结论

术前采用多模式和多专业的方法可能为保持或增强生理完整性和优化手术恢复提供机会。研究表明，康复对术后功能能力和早期恢复日常活动和健康相关的生活质量有积极影响。从患者的角度和临床结果测量以及验证指标反映康复的有意义的结果对于确定预康复是否降低高风险患者发生长期残疾的风险是必要的。

对护理实践的影响

泌尿肿瘤科护士在每个 ERAS 计划中都处于最前沿，并且在手术前筛查患者的常见风险因素、当前损伤和可能损害基线功能能力的限制方面至关重要。越来越多的标准化临床实施康复运动表明，显然需要进一步调查、优化多模式方法，并在可能最好地支持和促进这些举措的不同专业领域的医疗保健提供者之间进行公开讨论。