Importance of "muscle" and "intestine" training before major HPB surgery: A review.
bacterial translocation
prehabilitation
sarcopenia
short-chain fatty acids
synbiotics
Journal
Journal of hepato-biliary-pancreatic sciences
ISSN: 1868-6982
Titre abrégé: J Hepatobiliary Pancreat Sci
Pays: Japan
ID NLM: 101528587
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
revised:
22
09
2020
received:
02
08
2020
accepted:
23
09
2020
pubmed:
16
10
2020
medline:
16
10
2021
entrez:
15
10
2020
Statut:
ppublish
Résumé
Major hepato-pancreato-biliary (HPB) surgery is one of the most invasive abdominal surgeries. Through the experiences of several clinical trials, including those involving patients undergoing major HPB surgery, we have recognized the importance of "muscle" and "intestine" training before surgery. This review article summarizes the results of our clinical trials, specifically focusing on the importance of "muscle" and "intestine". The patients with low skeletal muscle mass or those with low functional exercise capacity showed a significantly worse postoperative course and poor long-term survival after surgery for HPB malignancy. The introduction of prehabilitation (preoperative physical and nutritional support) improved nutritional status and functional exercise capacity, even in patients with malignancy. Daily physical activity was correlated with nutritional status before surgery. These results indicated the usefulness of prehabilitation. The intestinal microenvironment, which is extrapolated from the fecal concentrations of short-chain fatty acids (SCFAs), showed a significant association with the incidence of surgery-induced bacterial translocation and postoperative infectious complications (POICs). The use of perioperative synbiotics not only increased the fecal levels of SCFAs but also prevented the incidence of POICs. A recent study also indicated that there are correlations between muscle mass and the intestinal microenvironment. Further investigation is required to determine the best "muscle" and "intestine" training protocol to improve the outcomes of major HPB surgeries.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
545-555Informations de copyright
© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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