Effect of home-based prehabilitation in an enhanced recovery after surgery program for patients undergoing colorectal cancer surgery during the COVID-19 pandemic.

BACKGROUND: Surgery remains the first curative treatment for colorectal cancer. Prehabilitation seems to attenuate the loss of lean mass in the early postoperative period. However, its long-term role has not been studied. Lockdown due to the COVID-19 pandemic has forced to carry out the prehabilitation program at home. This study aimed to assess the effect of home prehabilitation on body composition, complications, and hospital stay in patients undergoing oncological colorectal surgery. METHODS: A prospective and randomized clinical study was conducted in 20 patients operated of colorectal cancer during COVID-19 lockdown (13 March to 21 June 2020) in a single university clinical hospital. Patients were randomized into two study groups (10 per group): prehabilitation vs standard care. Changes in lean mass and fat mass at 45 and 90 days after surgery were measured using multifrequency bioelectrical impedance analysis. RESULTS: Prehabilitation managed to reduce hospital stay (4.8 vs 7.2 days, p = 0.052) and postoperative complications (20% vs 50%, p = 0.16). Forty-five days after surgery, the loss of lean mass decreased (1.7% vs 7.1%, p = 0.17). These differences in lean mass were attenuated at 90 days; however, the standard care group increased considerably their fat mass compared to the prehabilitation group (+ 8.72% vs - 8.16%). CONCLUSIONS: Home prehabilitation has proven its effectiveness, achieving an attenuation of lean mass loss in the early postoperative period and a lower gain in fat mass in the late postoperative period. In addition, it has managed to reduce hospital stays and postoperative complications. REGISTRATION NUMBER: This article is part of an ongoing, randomized, and controlled clinical trial approved by the ethics committee of our hospital and registered in ClinicalTrials.gov in August 2018 with registration number NCT03618329.

Aplicación de los criterios de EUSOMA en las unidades funcionales de mama de los países miembros de la Unión Europea / Application of the eusoma criteria in breast units in countries of the European Union

Todos los países de la Unión Europea se enfrentan a retos similares a la hora de ofrecer un tratamiento adecuado y de alta calidad a los pacientes oncológicos. Los “Requisitos de una Unidad de Mama” publicados en 2000 y resultado del trabajo de un grupo de expertos representan la opinión de la European Society of Mastology (EUSOMA) sobre los estándares de composición y funcionamiento necesarios para formar unidades de cáncer de mama de alta calidad. Hemos estudiado la aplicación de las recomendaciones y de los requisitos obligatorios: cantidad crítica o número mínimo de pacientes, composición y formación específica del personal médico, control de calidad, aplicación de protocolos, etc. Los datos se han obtenido a partir de una completa búsqueda bibliográfica, complementada con la información procedente de buscadores médicos, páginas web de sociedades científicas, asociaciones nacionales de lucha contra el cáncer, ministerios de sanidad, etc., de los países miembros de la Unión Europea. Se han actualizado las últimas actuaciones de la Comisión del Parlamento Europeo responsable del informe sobre el cáncer de mama. Hay diversos enfoques de atención multidisciplinaria de la enfermedad mamaria en algunos países europeos, como los desarrollados en el Reino Unido, Suecia, Italia, Francia o España. Sería conveniente disponer de una normativa europea común para poder mejorar el cuidado de nuestras pacientes (AU)

All the countries of the European Union face similar challenges when providing adequate and high quality treatment in oncology. A working party was established to consider what should comprise a specialist service and the “Requirements of a Breast Unit”, published in 2000, represent the opinion of the European Society of Mastology (EUSOMA) on the standards required for creating high quality Breast Cancer Units across Europe. We studied the application of the mandatory requisites and general recommendations of EUSOMA: critical mass, or minimum number of patients, core team (composition and specific training), quality assurance, and application of diagnostic and treatment protocols. A thorough literature search was performed and was completed with information from search tools, the web pages of scientific societies, national associations for the fight against cancer, and health ministries of the countries belonging to the European Union. We also analyzed the latest reports of the European Parliamentary Committee for breast cancer. Distinct approaches to the multidisciplinary management of breast disease can be found in the United Kingdom, Sweden, Italy, France and Spain. A common European standard would be useful to improve the care provided to patients (AU)

[Application of the EUSOMA criteria in breast units in countries of the European Union]. / Aplicación de los criterios de EUSOMA en las unidades funcionales de mama de los países miembros de la Unión Europea.

All the countries of the European Union face similar challenges when providing adequate and high quality treatment in oncology. A working party was established to consider what should comprise a specialist service and the Requirements of a Breast Unit, published in 2000, represent the opinion of the European Society of Mastology (EUSOMA) on the standards required for creating high quality Breast Cancer Units across Europe. We studied the application of the mandatory requisites and general recommendations of EUSOMA: critical mass, or minimum number of patients, core team (composition and specific training), quality assurance, and application of diagnostic and treatment protocols. A thorough literature search was performed and was completed with information from search tools, the web pages of scientific societies, national associations for the fight against cancer, and health ministries of the countries belonging to the European Union. We also analyzed the latest reports of the European Parliamentary Committee for breast cancer. Distinct approaches to the multidisciplinary management of breast disease can be found in the United Kingdom, Sweden, Italy, France and Spain. A common European standard would be useful to improve the care provided to patients.