作者
Robert Walker,Sowrav Barman,Philip H. Pucher,Pritam Singh,Greg Whyte,John Moore,Fiona Huddy,Orla Evans,G. Tham,Zainab Noor Z,Juliette Hussey,Malcolm West,Sandy Jack,Denny Levett,Timothy J. Underwood,James Gossage,Javed Sultan,Nicholas Maynard,Timothy E. Miller,Michael P. W. Grocott,Andrew Davies,Andrew Davies,Robert Walker,Sowrav Barman,Philip H. Pucher,Pritam Singh,Timothy E. Miller,Michael P. W. Grocott,Rachel E. Brown,Mike Browning,Karen A. Butler,Orla Evans,James Gossage,Emer Guinan,Fiona Huddy,Juliette Hussey,Sandy Jack,Zainab Noor,Denny Levett,Sheraz R. Markar,Nick Maynard,John G. Moore,Krishna Moorthy,Jim Pate,Christopher J. Peters,Alexander W. Phillips,Shaun R. Preston,Richard J.E. Skipworth,Javed Sultan,Malcolm West,Greg Whyte,Bas P. L. Wijnhoven
摘要
Abstract Background Prehabilitation is safe, feasible and may improve a range of outcomes in patients with oesophago-gastric cancer (OGC). Recent studies have suggested the potential of prehabilitation to improve body composition, sarcopenia and physical fitness, reduce surgical complications and improve quality of life. Despite this, prehabilitation services are not offered throughout all OGC centres in the UK. Where prehabilitation is offered, delivery and definitions vary significantly, as do funding sources and access. Methods A professional association endorsed series of consensus meetings were conducted using a modified Delphi process developed by the Peri-Operative Quality Initiative (POQI) to identify and refine consensus statements relating to the development and delivery of prehabilitation services for OGC patients. Participants from a variety of disciplines were identified based on a track record of published studies in the field of prehabilitation and/or practice experience encompassing prehabilitation of OGC patients. Approval from the POQI board was obtained and independent supervision provided by POQI. Results A total of 20 statements were developed and agreed by 26 participants over a preliminary meeting and 2 semi-structured formal POQI meetings. Ten research themes were identified. In the case of one statement, consensus was not reached and the statement was recorded and developed into a research theme. A strong recommendation was made for the majority of the consensus statements (17 of 20). Discussion Consensus statements encompassing the interventions and outcomes of prehabilitation services in oesophago-gastric cancer surgery have been developed to inform the implementation of programmes.