Preoperative Prehabilitation for Sarcopenic Patients Prior to Pancreatic Surgery for Cancer

Prehabilitaion Program for Sarcopenic Patients Prior to Pancreaticoduodenectomy for Periampullary Malignant Tumors

Major digestive surgery is associated with a significant rate of postoperative complications. To improve postoperative outcome, efforts are focused on postoperative course leading to the concept of rehabilitation. However, the rehabilitation concept does not allow to improve muscular and functional reserves at the time of surgery. Sarcopenia is a condition characterized by loss of skeletal muscle mass and function. Also, the prevalence of sarcopenia in patients with cancer is high and has a prevalence of around 25% in patients with pancreatic cancer, with a considerable impact on postoperative and survival outcomes.

The hypothesis is the preoperative management of sarcopenia by a rehabilitation program could improve patients' operative outcomes by reducing the rate of postoperative complications.

Inclusion Criteria:

• Patients undergoing pancreaticoduodenectomy for cancer
• Sarcopenic status

Exclusion Criteria:

• Age younger than 18 years
• Medical contraindications including cardiovascular disease or clinically significant vascular disease
• Physical inability to exercise
• Emergent surgery