Authors (including presenting author) :
Chu KL(1), Wong MN (2)
Affiliation :
(1)Department of Anaesthesiology, Pain Medicine and Operating Services, United Christian Hospital, (2) Nursing Services Division, United Christian Hospital
Keyword 1: :
Gynaecologic oncology
Keyword 2: :
Prehabiliation
Keyword 4: :
Surgical recovery
Keyword 5: :
Community rehabilitation
Introduction :
Enhanced Recovery After Surgery (ERAS) pathways improve outcomes in gynaecological oncology but overlook long-term rehabilitation and lifestyle change. Community-based prehabilitation-rehabilitation (PREHAB) models remain unevaluated in Hong Kong. Gynaecological oncology patients form a major public hospital caseload; integrating community PREHAB with ERAS fills this gap, optimizing tertiary resources and leveraging surgery as a teachable moment for sustained lifestyle change.
Objectives :
Evaluate feasibility, safety, and preliminary efficacy of a hospital-community PREHAB model for low to moderate-risk patients (ASA II, stable comorbidities), enabling community-led prehabilitation and rehabilitation while reserving tertiary resources for complex cases.
Methodology :
Prospective longitudinal cohort pilot at United Christian Hospital with NGO collaboration. All recruited patients received education using "Six Pillars of PREHAB" (6健復機) surgery school framework. The six pillars form the acronym PREHAB: P – Physical Activity & Exercise; R – Respiratory Health, Breathing Exercise & Oral Health; E – Eating & Nutritional Optimization; H – Health Management of Comorbidities; A – Avoid Vices (Smoking & Drinking); B – Brain Health & Cognitive Preparation. Thirty-four women aged ≥55 years were recruited and allocated to either standard ERAS care (n = 17) or PREHAB (n = 17), the latter comprised of 8 sessions of community-based prehabilitation and 12 sessions of community-based rehabilitation. The primary outcomes were postoperative complications, hospital length of stay (LOS), and perioperative biomarkers including haemoglobin and serum albumin. Secondary outcomes were functional capacity measured by the Six-Minute Walk Test (6MWT) and handgrip strength, skeletal muscle index (SMI), and patient satisfaction.
Result & Outcome :
PREHAB group showed higher preoperative Hb (13.02 vs 12.09 g/dL; p=0.044), shorter LOS (5.53 vs 6.24 days), +52.56 m 6MWT gain despite SMI decline, improved handgrip, no added complications, high satisfaction, and sustained healthy behaviours. This demonstrates feasibility of community-integrated PREHAB, operationalizing resource allocation for moderate-risk patients in community settings—prioritizing tertiary care for complex cases and promoting long-term lifestyle adoption.
