Purpose of review: The purpose of this study is to evaluate the role of physical exercise and nutrition interventions in adult patients before elective major surgery.
Recent findings: Exercise training before elective adult major surgery is feasible, safe, and efficacious, but the clinical effectiveness remains uncertain. Early data suggests a reduction in morbidity, length of stay, and quality of life, but the results of larger definitive studies are awaited. Nutritional interventions are less well evaluated and when they are, it is often in combination with exercise interventions as part of a prehabilitation package.
Summary: Studies evaluating exercise and nutrition interventions before elective major surgery in adults are producing encouraging early results, but definitive clinical evidence is currently very limited. Future research should focus on refining interventions, exploring mechanism, and evaluating the interactions between therapies and large-scale clinical effectiveness studies.
Keywords: Exercise; Mortality; Multimodal prehabilitation; Nutrition; Postoperative outcome; Stress of surgery.