Time to prepare: Preoperative risk assessment and prehabilitation to improve resilience in patients with colon or rectal cancer

Approximately 40% of the patients with colorectal cancer have not returned to their preoperative level of functioning 3 months after surgery and 30% of the patients experience a postoperative complication. Preparation (i.e., prehabilitation) is important as better and faster recovery is achieved in patients with higher preoperative levels of aerobic fitness. The current thesis showed that an extension of the time between cancer diagnosis and surgery of up to 7 weeks for the benefit of prehabilitation is safe. In addition, it was shown that a cardiopulmonary exercise test is a reliable test that can be used to identify patients at high risk for postoperative complications, and that high intensity interval training – in the short period before surgery – is more effective for improving a patient’s aerobic fitness than moderate intensity training. Lastly, the results showed that home-based E-health supported prehabilitation (tele-prehabilitation) in high-risk patients is feasible.