Review
Copyright ©The Author(s) 2022.
World J Gastroenterol. Jun 14, 2022; 28(22): 2403-2416
Published online Jun 14, 2022. doi: 10.3748/wjg.v28.i22.2403
Table 2 Recommendations for prehabilitation interventions prior to intestinal surgery in Crohn’s disease
Intervention

NutritionalNutritional support may be considered in case of impaired nutritional status and/or inadequate intake with regard to proteins and calories. Minimum duration of nutritional support is 1-2 wk and may be extended to 6-8 wk to fully benefit from the dietary intervention. EEN may be considered as nutritional support for immunomodulatory effect and reduction of postoperative complications. TPN seems a valid option only when enteral nutrition is contraindicated, not effective or tolerated
Physical fitnessPhysical exercise aerobic activity and muscular resistance training may be considered to improve physical fitness in the preoperative course. High-intensity physical exercise should be avoided due to risk of exacerbation of inflammation and symptoms
CD medicationWean off corticosteroids to a minimal dose (preferably < 20 mg) 6 wk prior to surgery. Consider cessation of anti-TNF-α agents (especially in case of therapy-refractory disease). If considered, a time-interval of 4 wk (ADA) or 6-8 wk (IFX) seems appropriate
Laboratory assessmentPreoperative intravenous iron therapy is recommended in case of iron deficiency anemia in the preoperative course. In case of hypoalbuminemia and an impaired nutritional status, nutritional support is advised (see nutritional and physical status)
SmokingPreoperative cessation is recommended (e.g., within smoking cessation program)
Psychological statusProvide individualized psychosocial support or refer to psychologist