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Volume 16
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Review

Multimodal Prehabilitation for Patients with Crohn’s Disease Scheduled for Major Surgery: A Narrative Review

by
Camilla Fiorindi
1,2,*,
Francesco Giudici
3,
Giuseppe Dario Testa
2,4,
Lorenzo Foti
2,5,
Sara Romanazzo
1,2,
Cristina Tognozzi
1,2,
Giovanni Mansueto
1,2,
Stefano Scaringi
3,
Francesca Cuffaro
1,
Anita Nannoni
1,
Mattias Soop
6 and
Gabriele Baldini
1,2,5
1
Department of Health Science, University of Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy
2
Multimodal Prehabilitation Center, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla 6, 50135 Florence, Italy
3
Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 6, 50135 Florence, Italy
4
Division of Geriatric and Intensive Care Medicine, University of Florence, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy
5
Section of Anesthesiology and Intensive Care, University of Florence, Largo Brambilla 3, 50139 Florence, Italy
6
Department for IBD and Intestinal Failure Surgery, Karolinska University Hospital, SE 177 76 Stockholm, Sweden
*
Author to whom correspondence should be addressed.
Nutrients 2024, 16(11), 1783; https://doi.org/10.3390/nu16111783
Submission received: 29 April 2024 / Revised: 25 May 2024 / Accepted: 5 June 2024 / Published: 6 June 2024
(This article belongs to the Special Issue Nutritional Elements of Enhanced Recovery after Surgery (ERAS) Programs: From Prehabilitation to Postoperative Recovery)
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Abstract

Approximately 15–50% of patients with Crohn’s disease (CD) will require surgery within ten years following the diagnosis. The management of modifiable risk factors before surgery is essential to reduce postoperative complications and to promote a better postoperative recovery. Preoperative malnutrition reduced functional capacity, sarcopenia, immunosuppressive medications, anemia, and psychological distress are frequently present in CD patients. Multimodal prehabilitation consists of nutritional, functional, medical, and psychological interventions implemented before surgery, aiming at optimizing preoperative status and improve postoperative recovery. Currently, studies evaluating the effect of multimodal prehabilitation on postoperative outcomes specifically in CD are lacking. Some studies have investigated the effect of a single prehabilitation intervention, of which nutritional optimization is the most investigated. The aim of this narrative review is to present the physiologic rationale supporting multimodal surgical prehabilitation in CD patients waiting for surgery, and to describe its main components to facilitate their adoption in the preoperative standard of care.
Keywords: Crohn’s disease; Enhanced Recovery After Surgery (ERAS); prehabilitation; multimodal; nutrition; surgery Crohn’s disease; Enhanced Recovery After Surgery (ERAS); prehabilitation; multimodal; nutrition; surgery

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MDPI and ACS Style

Fiorindi, C.; Giudici, F.; Testa, G.D.; Foti, L.; Romanazzo, S.; Tognozzi, C.; Mansueto, G.; Scaringi, S.; Cuffaro, F.; Nannoni, A.; et al. Multimodal Prehabilitation for Patients with Crohn’s Disease Scheduled for Major Surgery: A Narrative Review. Nutrients 2024, 16, 1783. https://doi.org/10.3390/nu16111783

AMA Style

Fiorindi C, Giudici F, Testa GD, Foti L, Romanazzo S, Tognozzi C, Mansueto G, Scaringi S, Cuffaro F, Nannoni A, et al. Multimodal Prehabilitation for Patients with Crohn’s Disease Scheduled for Major Surgery: A Narrative Review. Nutrients. 2024; 16(11):1783. https://doi.org/10.3390/nu16111783

Chicago/Turabian Style

Fiorindi, Camilla, Francesco Giudici, Giuseppe Dario Testa, Lorenzo Foti, Sara Romanazzo, Cristina Tognozzi, Giovanni Mansueto, Stefano Scaringi, Francesca Cuffaro, Anita Nannoni, and et al. 2024. "Multimodal Prehabilitation for Patients with Crohn’s Disease Scheduled for Major Surgery: A Narrative Review" Nutrients 16, no. 11: 1783. https://doi.org/10.3390/nu16111783

APA Style

Fiorindi, C., Giudici, F., Testa, G. D., Foti, L., Romanazzo, S., Tognozzi, C., Mansueto, G., Scaringi, S., Cuffaro, F., Nannoni, A., Soop, M., & Baldini, G. (2024). Multimodal Prehabilitation for Patients with Crohn’s Disease Scheduled for Major Surgery: A Narrative Review. Nutrients, 16(11), 1783. https://doi.org/10.3390/nu16111783

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