Abstract
Purpose
Major hepatic resections are performed for primary hepatobiliary malignancies, metastatic disease, and benign lesions. Patients with chronic liver disease, including cirrhosis and steatosis, are at an elevated risk of malnutrition and impaired strength and exercise capacity, deficits which cause increased risk of postoperative complications and mortality. The aims of this report are to discuss the pathophysiology of changes in nutrition, exercise capacity, and muscle strength in patient populations likely to require major hepatectomy, and review recommendations for preoperative evaluation and optimization.
Methods
Nutritional and functional impairment in preoperative hepatectomy patients, especially those with underlying liver disease, have a complex and multifactorial physiologic basis that is not completely understood.
Results
Recognition of malnutrition and compromised strength and exercise tolerance preoperatively can be difficult, but is critical in providing the opportunity to intervene prior to major hepatic resection and potentially improve postoperative outcomes. There is promising data on a variety of nutritional strategies to ensure adequate intake of calories, proteins, vitamins, and minerals in patients with cirrhosis and reduce liver size and degree of fatty infiltration in patients with hepatic steatosis. Emerging evidence supports structured exercise programs to improve exercise tolerance and counteract muscle wasting.
Conclusions
The importance of nutrition and functional status in patients indicated for major liver resection is apparent, and emerging evidence supports structured preoperative preparation programs involving nutritional intervention and exercise training. Further research is needed in this field to develop optimal protocols to evaluate and treat this heterogeneous cohort of patients.
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References
Weinmann A, Braga M, Carli F, Higashiguchi T et al (2017) ESPEN guideline: clinical nutrition in surgery. Clin Nut 36(3):623–650. https://doi.org/10.1016/j.clnu.2017.02.013
Sungurtekin H, Sungurtekin U, Balci C, Zencir M, Erdem E (2004) The influence of nutritional status on complications after major intraaabdominal surgery. J Am Coll Nutr 23(3):227–232. https://doi.org/10.1080/07315724.2004.10719365
Dempsey DT, Mullen J, Buzby GP (1988) The link between nutritional status and clinical outcome: can nutritional intervention modify it? Am J Clin Nutr 47(2 Suppl):352–356
Evans DC, Martindale R, Kiraly LN, Jones CM (2013) Nutrition optimization prior to surgery. Nutr Clin Pract 29(1):10–21. https://doi.org/10.1177/0884533613517006
Bozzetti F (2002) Rationale and indications for preoperative feeding of malnourished surgical cancer patients. Nutrition 18(11/12):953–959. https://doi.org/10.1016/S0899-9007(02)00988-7
Gallagher-Allred CR, Voss A, Finn SC, McCamish MA (1996) Malnutrition and clinical outcomes: the case for medical nutrition therapy. J Am Diet Assoc 96(4):361–366. https://doi.org/10.1016/S0002-8223(96)00099-5
Pichard C, Kyle U, Morabia A, Perrier A, Vermeulen B, Unger P (2004) Nutritional assessment: lean body mass depletion at hospital admission is associated with an increased length of stay. Am J Clin Nutr 79(4):613–618
Gianotti L, Braga M, Nespoli L et al (2002) A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. Gastroenterology 122(7):1763–1770. https://doi.org/10.1053/gast.2002.33587
Gustafsson UO, Oppelstrup H, Thorell A et al (2016) Adherence to the ERAS protocol is associated with 5-year survival after colorectal surgery: a retrospective cohort study. World J Surg 40(7):1741–1747. https://doi.org/10.1007/s00268-016-3460-y
Horowitz M, Neeman E, Sharon E (2015) Exploiting the critical perioperative period to improve long-term cancer outcomes. Nat Rev Clin Oncol 12(4):213–226. https://doi.org/10.1038/nrclinonc.2014.224
Toh SY, Zarshenas N, Jorgensen J (2009) Prevalence of nutrient deficiencies in bariatric patients. Nutrition 25(11-12):1150–1156. https://doi.org/10.1016/j.nut.2009.03.012
Wells JCK (2013) Obesity as malnutrition: the dimensions beyond energy balance. Eur J Clin Nut 67(5):507–512. https://doi.org/10.1038/ejcn.2013.31
Kerns JC, Arundel C, Chawla LS (2015) Thiamin deficiency in people with obesity. Adv Nutr 6(2):147–153. https://doi.org/10.3945/an.114.007526
Prado CM, Cushen S, Orsso CE, Ryan AM (2016) Sarcopenia and cachexia in the era of obesity: clinical and nutritional impact. Proc Nutr Soc 75(02):188–198. https://doi.org/10.1017/S0029665115004279
Batsis JA, Mackenzie T, Lopez-Jimenez F, Bartels SJ (2014) Sarcopenia, sarcopenic obesity and mortality in older adults: results from the National Health and Nutrition Examination Survey III. Eur J Clin Nut 68(9):1001–1007. https://doi.org/10.1038/ejcn.2014.117
Tsai S (2012) Importance of lean body mass in the oncologic patient. Nutr Clin Pract 27(5):593–598. https://doi.org/10.1177/0884533612457949
Brady MC, Kinn S, Stuart P, Ness V (2003) Preoperative fasting for adults to prevent perioperative complications. Cochrane Database Syst Rev 4. https://doi.org/10.1002/14651858.CD004423
Reddy SK, Barbas A, Turley RS et al (2011) A standard definition of major hepatectomy: resection of four or more liver segments. HPB 13(7):494–502. https://doi.org/10.1111/j.1477-2574.2011.00330.x
Ciuni R, Biondi A, Grosso G (2011) Nutritional aspects in patient undergoing liver resection. Updat Surg 63(4):249–252. https://doi.org/10.1007/s13304-011-0121-4
Redaelli CA, Wagner M, Krähenbühl L, Gloor B, Schilling MK, Dufour JF, Büchler MW (2002) Liver surgery in the era of tissue-preserving resections: early and late outcome in patients with primary and secondary hepatic tumors. World J Surg 26(9):1126–1132. https://doi.org/10.1007/s00268-002-6321-9
Veteläinen R, van Vliet A, Gouma DJ, van Gulik TM (2007) Steatosis as a risk factor in liver surgery. Ann Surg 245(1):20–30. https://doi.org/10.1097/01.sla.0000225113.88433.cf
Fan ST, Lo C, Lai ECS et al (1994) Perioperative nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma. N Engl J Med 331(23):1300–1306. https://doi.org/10.1056/NEJM199412083312303
Van den Broek MAJ, Olde Damink S, Dejong CHC et al (2008) Liver failure after partial hepatic resection: definition, pathophysiology, risk factors and treatment. Liver Int 28(6):767–780. https://doi.org/10.1111/j.1478-3231.2008.01777.x
Altekruse SF, Henley S, Cucinelli et al (2014) Changing hepatocellular carcinoma incidence and liver cancer mortality rates in the United States. Am J Gastroenterol 109(4):542–553. https://doi.org/10.1038/ajg.2014.11
Rahib L, Smith B, Aizenberg R, Rosenweig AB, Fleshman JM, Matrisian LM (2014) Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res 74(11):2913–2921. https://doi.org/10.1158/0008-5472.CAN-14-0155
Tang A, Hallouch O, Chernyak V et al (2017) Epidemiology of hepatocellular carcinoma: target population for surveillance and diagnosis. Abdom Radiol. https://doi.org/10.1007/s00261-017-1209-1
White DL, Thrift A, Kanwal F et al (2017) Incidence of hepatocellular carcinoma in all 50 United States from 2000-2012. Gastroenterology 152(4):812–820. https://doi.org/10.1053/j.gastro.2016.11.020
El-Serag HB, Davila J, Petersen NJ et al (2003) The continuing increase in the incidence of hepatocellular carcinoma. Ann Intern Med 139(10):817–823. https://doi.org/10.7326/0003-4819-139-10-200311180-00009
Bruix J, Reig M, Sherman M (2016) Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology 150(4):835–853. https://doi.org/10.1053/j.gastro.2015.12.041
Vitale A, Saracino E, Boccagni P et al (2009) Validation of the BCLC prognostic system in surgical hepatocellular cancer patients. Transpl Proc 41(4):1260–1263. https://doi.org/10.1016/j.transproceed.2009.03.054
Katagiri S, Yamamoto M (2014) Multidisciplinary treatments for hepatocellular carcinoma with major portal vein tumor thrombus. Surg Today 44(2):219–226. https://doi.org/10.1007/s00595-013-0585-6
Kokudo T, Hasegawa K, Matsuyama Y et al (2016) Survival benefit of liver resection for hepatocellular carcinoma associated with portal vein invasion. J Hepatol 65(5):938–943. https://doi.org/10.1016/j.jhep.2016.05.044
Lee JM, Jang B, Lee YJ et al (2016) Survival outcomes of hepatic resection compared with transarterial chemoembolization or Sorafenib for hepatocellular carcinoma with portal vein tumor thrombosis. Clin Mol Hepatol 22(16):160–167. 10.18632/oncotarget.8312
Cheung K, Lee S, Raman M (2012) Prevalence and mechanisms of malnutrition in patients with advanced liver disease, and nutrition management strategies. Clin Gastroenterol Hepatol 10(2):117–125. https://doi.org/10.1016/j.cgh.2011.08.016
Huisman EJ, Trip E, Siersema PD et al (2011) Protein energy malnutrition predicts complications in liver cirrhosis. Eur J Gastroenterol Hepatol 23(11):982–989. https://doi.org/10.1097/MEG.0b013e32834aa4bb
Kalaitzakis E, Simrén M, Olsson R et al (2006) Gastrointestinal symptoms in patients with liver cirrhosis: associations with nutritional status and health-related quality of life. Scand J Gastroenterol 41(12):1464–1472. https://doi.org/10.1080/00365520600825117
O’Brien A, Williams R (2008) Nutrition in end-stage liver disease: principles and practice. Gastroenterology 134:1729–1740. https://doi.org/10.1053/j.gastro.2008.02.001
Kondrup J (2006) Nutrition in end stage liver disease. Best Pract Res Clin Gastroenterol 20(3):547–560. https://doi.org/10.1016/j.bpg.2006.02.001
Campillo B, Richardet J, Bories PN (2005) Enteral nutrition in severely malnourished and anorectic cirrhotic patients in clinical practice: benefit and prognostic factors. Gastroenterol Clin Biol 29(6-7):645–651. https://doi.org/10.1016/S0399-8320(05)82150-5
Gunsar F, Raimondo M, Jones S et al (2006) Nutritional status and prognosis in cirrhotic patients. Aliment Pharmacol Ther 24(4):563–572. https://doi.org/10.1111/j.1365-2036.2006.03003.x
Carvalho L, Parise E (2006) Evaluation of nutritional status of nonhospitalized patients with liver cirrhosis. Arq Gasteroenterol 43(4):269–274. https://doi.org/10.1590/S0004-28032006000400005
Guglielmi FW, Panella C, Buda A et al (2006) Nutritional state and energy balance in cirrhotic patients with or without hypermetabolism: multicentre prospective study by the ‘Nutritional Problems in Gastroenterology’ Section of the Italian Society of Gastroenterology (SIGE). Dig Liver Dis 37(9):681–688. https://doi.org/10.1016/j.dld.2005.03.010
Peng S, Plank L, McCall JL et al (2007) Body composition, muscle function, and energy expenditure in patients with liver cirrhosis: a comprehensive study. Am J Clin Nutr 85(5):1257–1266
Merli M, Nicolini G, Angeloni S et al (2002) Malnutrition is a risk factor in cirrhotic patients undergoing surgery. Nutrition 18(11-12):978–986. https://doi.org/10.1016/S0899-9007(02)00984-X
Muller MJ, Böttcher J, Selberg O (1999) Hypermetabolism in clinically stable patients with liver cirrhosis. Am J Clin Nutr 69(6):1194–1201
Riggio O, Angeloni S, Ciuffa L et al (2003) Malnutrition is not related to alterations in energy balance in patients with stable liver cirrhosis. Clin Nut 22(6):553–559. https://doi.org/10.1016/S0261-5614(03)00058-X
Tsiaousi ET, Hatzitolios A, Trygonis SK et al (2008) Malnutrition in end stage liver disease: recommendations and nutritional support. J Gastroenterol Hepatol 23(4):527–533. https://doi.org/10.1111/j.1440-1746.2008.05369.x
Le Moine O, Marchant A, Groote DD et al (1995) Role of defective monocyte interleukin-10 release in tumor necrosis factor-alpha overproduction in alcoholic cirrhosis. Hepatology 22(5):1436–1439. https://doi.org/10.1002/hep.1840220516
Plauth M, Schütz E (2002) Cachexia in liver cirrhosis. Int J Cardiol 85(1):83–87. https://doi.org/10.1016/S0167-5273(02)00236-X
Marchesini G, Bianchi G, Amodio et al (2001) Factors associated with poor health-related quality of life of patients with cirrhosis. Gastroenterology 120(1):170–178. https://doi.org/10.1053/gast.2001.21193
Owen OE, Reichle F, Mozzoli MA et al (1981) Hepatic, gut, and renal substrate flux rates in patients with hepatic cirrhosis. J Clin Invest 68(1):240–252. https://doi.org/10.1172/JCI110240
Owen OE, Trapp V, Reichard GA Jr et al (1983) Nature and quantity of fuels consumed in patients with alcoholic cirrhosis. J Clin Invest 72(5):1821–1832. https://doi.org/10.1172/JCI111142
Merli M, Leonetti F, Riggio O et al (1999) Glucose intolerance and insulin resistance in cirrhosis are normalized after liver transplantation. Hepatology 30(3):649–654. https://doi.org/10.1002/hep.510300306
Khanna S, Gopalan S (2007) Role of branched-chain amino acids in liver disease: the evidence for and against. Curr Opin Clin Nut Metab Care 10(3):297–303. https://doi.org/10.1097/MCO.0b013e3280d646b8
Mardini HA, Douglass A, Record C (2006) Amino acid challenge in patients with cirrhosis and control subjects: ammonia, plasma amino acid, and EEG changes. Metab Brain Dis 21(1):1–10. https://doi.org/10.1007/s11011-006-9006-5
Moscateillo SM, Marchesini G (2007) Diabetes and liver disease: an ominous association. Nutr Metab Cardiovasc Dis 17(1):63–70. https://doi.org/10.1016/j.numecd.2006.08.004
Areth J, Narra S, Nair S (2010) Prevalence of vitamin D deficiency in chronic liver disease. Dig Dis Sci 55(9):2624–2628. https://doi.org/10.1007/s10620-009-1069-9
Detsky AS, McLaughlin J, Baker JP et al (1987) What is subjective global assessment of nutritional status? J Parenter Enter Nutr 11(1):8–13. https://doi.org/10.1177/014860718701100108
Henkel AS, Buchman A (2006) Nutritional support in patients with chronic liver disease. Nat Clin Pract Gastroenterol Hepatol 3(4):202–209. https://doi.org/10.1038/ncpgasthep0443
Huynh DK, Selvanderan S, Harley HAJ et al (2015) Nutritional care in hospitalized patients with chronic liver disease. World J Gasteroenterol 21(11):12835–12842. https://doi.org/10.1097/MEG.0b013e32834aa4bb
Plauth M, Cabré E, Riggio O et al (2006) ESPEN guidelines on enteral nutrition: liver disease. Clin Nut 25(2):285–294. https://doi.org/10.1016/j.clnu.2006.01.018
Selberg O, Selberg D (2002) Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol 86(6):509–516. https://doi.org/10.1007/s00421-001-0570-4
Pinato DJ, North B, Sharma R (2012) A novel, externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma: the prognostic nutritional index (PNI). Br J Cancer 106(8):1439–1445. https://doi.org/10.1038/bjc.2012.92
Chan AWH, Chan S, Wong GLH et al (2015) Prognostic nutritional index (PNI) predicts tumor recurrence of very early/early stage hepatocellular carcinoma after surgical resection. Ann Surg Oncol 22(13):4138–4148. https://doi.org/10.1245/s10434-015-4516-1
Okamura Y, Ashida R, Ito T et al (2015) Preoperative neutrophil to lymphocyte ratio and prognostic nutritional index predict overall survival after hepatectomy for hepatocellular carcinoma. World J Surg 39(6):1501–1509. https://doi.org/10.1007/s00268-015-2982-z
Takagi K, Yagi T, Umeda Y (2017) Preoperative controlling nutritional status (CONUT) score for assessment of prognosis following hepatectomy for hepatocellular carcinoma. World J Surg 41(9):2353–2360. https://doi.org/10.1007/s00268-017-3985-8
Iseki Y, Shibutani M, Maeda K et al (2015) Impact of the preoperative controlling nutritional status (CONUT) score on the survival after curative surgery for colorectal cancer. PLoS One 10(7):e0132488. https://doi.org/10.1371/journal.pone.0132488
Ignacio de Ulíbarri J, G-Ma N, de Villar GP et al (2005) CONUT: a tool for controlling nutritional status: first validation in a hospital population. Nutr Hosp 20(1):38–45
Bolder U, Brune A, Schmidt S et al (1999) Preoperative assessment of mortality risk in hepatic resection by clinical variables: a multivariate analysis. Liver Transpl Surg 5(3):227–237. https://doi.org/10.1002/lt.500050302
Schütte K, Schuls C, Malfertheiner P (2015) Nutrition and hepatocellular cancer. Gastrointest Tumors 2(4):188–194. https://doi.org/10.1159/000441822
Miwa Y, Shiraki M, Kato M et al (2000) Improvement of fuel metabolism by nocturnal energy supplementation in patients with liver cirrhosis. Hepatol Res 18(3):184–189. https://doi.org/10.1016/S1386-6346(99)00100-X
Plank LD, Gane E, Peng S et al (2008) Nocturnal nutritional supplementation improves total body protein status of patients with liver cirrhosis: a randomized 12-month trial. Hepatology 48(2):557–566. https://doi.org/10.1002/hep.22367
Matos C, Porayko M, Francisco-Ziller N (2002) Nutrition and chronic liver disease. J Clin Gasteroenterol 35(5):391–397. https://doi.org/10.1097/00004836-200211000-00007
Gluud L, Dam G, Les I, Marchesini G, Borre M, Aagaard N, Vilstrup H (2017) Branched-chain amino acids for people with hepatic encephalopathy. Cochrane Database Syst Rev 5. https://doi.org/10.1002/14651858.CD001939.pub4
Morihara D, Iwata K, Hanano T (2012) Late-evening snack with branched-chain amino acids improves liver function after radiofrequency ablation for hepatocellular carcinoma. Hepatol Res 42(7):658–667. https://doi.org/10.1111/j.1872-034X.2012.00969.x
Nishikawa H, Osaki Y, Iguchi E et al (2013) The effect of long-term supplementation with branched-chain amino acid granules in patients with hepatitis C virus-related hepatocellular carcinoma after radiofrequency ablation. J Clin Gastroenterol 47(4):359–366. https://doi.org/10.1097/MCG.0b013e31826be9ad
Nishikawa H, Osaki Y, Inuzuka T et al (2012) Branched-chain amino acid treatment before transcatheter arterial chemoembolization for hepatocellular carcinoma. World J Gasteroenterol 18(12):1379–1384. https://doi.org/10.3748/wjg.v18.i12.1379
Ichikawa K, Okabayashi T, Maeda H et al (2012) Oral supplementation of branched-chain amino acids reduces early recurrence after hepatic resection in patients with hepatocellular carcinoma: a prospective study. Surg Today 43(7):720–726. https://doi.org/10.1007/s00595-012-0288-4
Mikagi K, Kawahara R, Kinoshita H, Aoyagi S (2011) Effect of preoperative immunonutrition in patients undergoing hepatectomy; a randomized controlled trial. Kurume Med J 58:1–8
Rayes N, Seehofer D, Hansen S et al (2002) Early enteral supply of lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients. Transplantation 74(1):123–128. https://doi.org/10.1097/00007890-200207150-00021
Rayes N, Seehofer D, Theruvath T et al (2005) Supply of pre- and probiotics reduces bacterial infection rates after liver transplantation—a randomized, double-blind trial. Am J Transplant 5(1):125–130. https://doi.org/10.1111/j.1600-6143.2004.00649.x
Usami M, Miyoshi M, Kanbara Y et al (2011) Effects of perioperative synbiotic treatment on infectious complications, intestinal integrity, and fecal flora and organic acids in hepatic surgery with or without cirrhosis. J Parenter Enter Nutr 35(3):317–328. https://doi.org/10.1177/0148607110379813
Kanazawa H, Nagino M, Kamiya S et al (2005) Synbiotics reduce post-operative infectious complications: a randomized controlled trial in biliary cancer patients undergoing hepatectomy. Langenbeck's Arch Surg 390(2):104–113. https://doi.org/10.1007/s00423-004-0536-1
Sugawara G, Nagino M, Nishio H et al (2006) Perioperative synbiotic treatment to prevent postoperative infectious complications in biliary cancer surgery: a randomized controlled trial. Ann Surg 244(5):706–714. https://doi.org/10.1097/01.sla.0000219039.20924.88
Richter B, Schmandra T, Golling M, Bechstein WO (2006) Nutritional support after open liver resection: a systematic review. Dig Surg 23(3):139–145. https://doi.org/10.1159/000094345
Pessaux P, Chenard M, Bachellier P, Jaeck D (2010) Consequences of chemotherapy on resection of colorectal liver metastases. J Visc Surg 147(4):e193–e201. https://doi.org/10.1016/j.jviscsurg.2010.06.004
Ribeiro HSC, Costa WL Jr, Diniz AL et al (2013) Extended preoperative chemotherapy, extent of liver resection and blood transfusion are predictive factors of liver failure following resection of colorectal liver metastasis. EJSO 39(4):380–385. https://doi.org/10.1016/j.ejso.2012.12.020
Read JA, Boris Choy S, Beale PJ et al (2006) Evaluation of nutritional and inflammatory status of advanced colorectal cancer patents and its correlation with survival. Nutr Cancer 55(78–85):78–85. https://doi.org/10.1207/s15327914nc5501_10
Kleiner DE, Brunt E, Van Natta M et al (2005) Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 41(6):1313–1321. https://doi.org/10.1002/hep.20701
Reeves JG, Suriawinata A, Ng DP, Holubar SD, Mills JB, Barth RJ Jr (2013) Short-term preoperative diet modification reduces steatosis and blood loss in patients undergoing liver resection. Surgery 154(5):1031–1037. https://doi.org/10.1016/j.surg.2013.04.012
Sullivan S (2010) Implications of diet on nonalcoholic fatty liver disease. Curr Opin Gastroenterol 26(2):160–164. https://doi.org/10.1097/MOG.0b013e3283358a58
Gholam PM, Flancbaum L, Machan JT, Charney DA, Kotler DP (2017) Nonalcoholic fatty liver disease in severely obese subjects. Am J Gastroenterol 102(2):399–408. https://doi.org/10.1111/j.1572-0241.2006.01041.x
de Meijer VE, Kalish B, Pruder M, Ijzermans JNM (2010) Systematic review and meta-analysis of steatosis as a risk factor in major hepatic resection. Br J Surg 97(9):1331–1339. https://doi.org/10.1002/bjs.7194
Gomez D, Malik H, Bonney GK, Wong V, Toogood GJ, Lodge JPA, Prasad KR (2007) Steatosis predicts postoperative morbidity following hepatic resection for colorectal metastasis. Br J Surg 94(11):1395–1402. https://doi.org/10.1002/bjs.5820
Kooby DA, Fong Y, Suriawinata A et al (2003) Impact of steatosis on perioperative outcome following hepatic resection. J Gastrointest Surg 7(8):1034–1044. https://doi.org/10.1016/j.gassur.2003.09.012
Zhao J, van Mierlo K, Gómez-Ramírez J et al (2017) Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases. BJS 104(8):990–1002. https://doi.org/10.1002/bjs.10572
Nomura F, Ohnishi K, Ochiai T, Okuda K (1987) Obesity-related nonalcoholic fatty liver: CT features and follow-up studies after low-calorie diet. Radiology 162(3):845–847. https://doi.org/10.1148/radiology.162.3.3809503
Fris RJ (2004) Preoperative low energy diet diminishes liver size. Obes Surg 14(9):1165–1170. https://doi.org/10.1381/0960892042386977
Ryan P, Nanji S, Pollett A, Moore M, Moulton CA, Gallinger S, Guindi M (2010) Chemotherapy-induced liver injury in metastatic colorectal cancer: semiquantitative histologic analysis of 334 resected liver specimens shows that vascular injury but not steatohepatitis is associated with preoperative chemotherapy. Am J Surg Pathol 34(6):784–791. https://doi.org/10.1097/PAS.0b013e3181dc242c
Nakano H, Oussoultzoglou E, Rosso E et al (2008) Sinusoidal injury increases morbidity after major hepatectomy in patients with colorectal liver metastases receiving preoperative chemotherapy. Ann Surg 247(1):118–124. https://doi.org/10.1097/SLA.0b013e31815774de
Vauthey JN, Pawlik T, Ribero D et al (2006) Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. J Clin Oncol 24(13):2065–2072. https://doi.org/10.1200/JCO.2005.05.3074
Pawlik TM, Olino K, Gleisner A, Torbenson M, Schulick R, Choti MA (2007) Preoperative chemotherapy for colorectal liver metastases: impact on hepatic histology and postoperative outcome. J Gastrointest Surg 11(7):860–868. https://doi.org/10.1007/s11605-007-0149-4
Wolf PS, Park J, Bao F et al (2013) Preoperative chemotherapy and the risk of hepatotoxicity and morbidity after liver resection for metastatic colorectal cancer: a single institution experience. J Am Coll Surg 216(1):41–49. https://doi.org/10.1016/j.jamcollsurg.2012.08.030
Sahajpal A, Vollmer CM Jr, Dixon E et al (2007) Chemotherapy for colorectal cancer prior to liver resection for colorectal cancer hepatic metastases does not adversely affect peri-operative outcomes. J Surg Oncol 95(1):22–27. https://doi.org/10.1002/jso.20632
Scoggins CR, Campbell M, Landry CS, Slomiany BA, Woodall CE, McMasters KM, Martin RCG (2009) Preoperative chemotherapy does not increase morbidity or mortality of hepatic resection for colorectal cancer metastases. Ann Surg Oncol 16(1):35–41. https://doi.org/10.1245/s10434-008-0190-x
Karoui M, Penna C, Amin-Hashem M et al (2006) Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg 243(1):1–7. https://doi.org/10.1097/01.sla.0000193603.26265.c3
Kishi Y, Zorzi D, Contreras CM et al (2010) Extended preoperative chemotherapy does not improve pathologic response and increases postoperative liver insufficiency after hepatic resection for colorectal liver metastases. Ann Surg Oncol 17(11):2870–2876. https://doi.org/10.1245/s10434-010-1166-1
Quan D, Gallinger S, Nhan C et al (2012) The role of liver resection for colorectal cancer metastases in an era of multimodality treatment: a systematic review. Surgery 151(6):860–870. https://doi.org/10.1016/j.surg.2011.12.018
Eriksson S, Eriksson K, Bondesson L (1986) Nonalcoholic steatohepatitis in obesity: a reversible condition. Acta Med Scand 220(1):83–88. https://doi.org/10.1111/j.0954-6820.1986.tb02733.x
Jones JC, Coombes J, Macdonald GA (2012) Exercise capacity and muscle strength in patients with cirrhosis. Liver Transpl 18(2):146–151. https://doi.org/10.1002/lt.22472
Bohannon RW, Magasi S, Bubela DJ et al (2012) Grip and knee extension muscle strength reflect a common construct among adults. Muscle Nerve 46(555–558):555–558. https://doi.org/10.1002/mus.23350
Campillo B, Fouet P, Bonnet JC et al (1990) Submaximal oxygen consumption in liver cirrhosis: evidence of severe functional aerobic impairment. J Hepatol 10(2):163–167. https://doi.org/10.1016/0168-8278(90)90046-T
Lemyze M, Dharancy S, Wallaert B (2013) Response to exercise in patients with liver cirrhosis: implications for liver transplantation. Dig Liver Dis 45(5):362–366. https://doi.org/10.1016/j.dld.2012.09.022
Terziyski K, Andonov V, Marinov B et al (2008) Exercise performance and ventilatory efficiency in patients with mild and moderate liver cirrhosis. Clin Exp Pharmacol Physiol 35(0):135–140. https://doi.org/10.1111/j.1440-1681.2007.04751.x
Weisinger GF, Quittan M, Zimmermann K et al (2001) Physical performance and health-related quality of life in men on a liver transplantation waiting list. J Rehabil Med 33:260–265
Epstein SK, Ciubotaru R, Zilberberg MD et al (1998) Analysis of impaired exercise capacity in patients with cirrhosis. Dig Dis Sci 43(8):1701–1707. https://doi.org/10.1023/A:1018867232562
Pieber K, Crevenna R, Nuhr MJ et al (2006) Aerobic capacity, muscle strength and health-related quality of life before and after orthotopic liver transplantation: preliminary data of an Austrian transplantation centre. J Rehabil Med 38(5):322–328. https://doi.org/10.1080/16501970600680288
Bernal W, Martin-Mateos R, Lipcsey M et al (2014) Aerobic capacity during cardiopulmonary exercise testing and survival with and without liver transplantation for patients with chronic liver disease. Liver Transpl 20(1):54–62. https://doi.org/10.1002/lt.23766
Dharancy S, Lemyze M, Boleslawski E et al (2008) Impact of impaired aerobic capacity on liver transplant candidates. Transplantation 86(8):1077–1083. https://doi.org/10.1097/TP.0b013e318187758b
Andersen H, Borre M, Jakobsen J et al (1998) Decreased muscle strength in patients with alcoholic liver cirrhosis in relation to nutritional status, alcohol abstinence, liver function, and neuropathy. Hepatology 27(5):1200–1206. https://doi.org/10.1002/hep.510270503
Tartar RE, Panzak G, Switala J et al (1997) Isokinetic muscle strength and its association with neuropsychological capacity in cirrhotic alcoholics. Alcohol Clin Exp Res 21(2):191–196. https://doi.org/10.1111/j.1530-0277.1997.tb03748.x
Montano-Loza AJ, Meza-Junco J, Prado CMM (2012) Muscle wasting is associated with mortality in patients with cirrhosis. Clin Gastroenterol Hepatol 10(2):166–173. https://doi.org/10.1016/j.cgh.2011.08.028
Ruiz-del-Árbol L, Serradilla R (2015) Cirrhotic cardiomyopathy. World J Gasteroenterol 21(41):11502–11521. https://doi.org/10.3748/wjg.v21.i41.11502
Carey EJ, Steidley D, Aqel BA (2010) Six-minute walk distance predicts mortality in liver transplant candidates. Liver Transpl 16(12):1373–1378. https://doi.org/10.1002/lt.22167
Tandon P, Low G, Mourtzakis M (2016) A model to identify sarcopenia in patients with cirrhosis. Clin Gastroenterol Hepatol 14(10):1473–1480. https://doi.org/10.1016/j.cgh.2016.04.040
Zenith L, Meena N, Ramadi A et al (2014) Eight weeks of exercise training increases aerobic capacity and muscle mass and reduces fatigue in patients with cirrhosis. Clin Gastroenterol Hepatol 12(11):1920–1926. https://doi.org/10.1016/j.cgh.2014.04.016
Debette-Gratien M, Tabouret T, Antonini MT et al (2014) Personalized adapted physical activity before liver transplantation: acceptability and results. Transplantation 99(1):145–150. https://doi.org/10.1097/TP.0000000000000245
Garcίa-Pagán JC, Santos C, Barberá JA et al (1996) Physical exercise increases portal pressure in patients with cirrhosis and portal hypertension. Gastroenterology 111(5):1300–1306. https://doi.org/10.1053/gast.1996.v111.pm8898644
Bandi JC, García-Pagán J, Escorsell A et al (1998) Effects of propranolol on the hepatic hemodynamic response to physical exercise in patients with cirrhosis. Hepatology 28(3):667–682. https://doi.org/10.1002/hep.510280312
Hulzebos EHJ, Smit Y, Helders PP JM, van Meeteren NLU (2014) Preoperative physical therapy for elective cardiac surgery patients (review). Cochrane Database Syst Rev (11). https://doi.org/10.1002/14651858.CD010118.pub2
Garcia RS, Yáñez-Brage M, Moolhuyzen EG, Riobo MS, Paz AL, Mate JMB (2017) Preoperative exercise training prevents functional decline after lung resection surgery: a randomized, single-blind controlled trial. Clin Rehab 31(8):1057–1067. https://doi.org/10.1177/0269215516684179
Carver TE, Mayo N, Andersen RE, Zavorsky GS (2011) Pilot investigation to evaluate changes in exercise capacity following a prehabilitation intervention among seriously obese patients awaiting bariatric surgery. Can J Diabetes 35(2):149. https://doi.org/10.1016/S1499-2671(11)52045-3
Hijazi Y, Gondal U, Aziz (2017) A systematic review of prehabilitation programs in abdominal cancer surgery. Int J Surg 39:156–162. https://doi.org/10.1016/j.ijsu.2017.01.111
Dunne DEJ, Jack S, Jones RP et al (2016) Randomized clinical trial of prehabilitation before planned liver resection. Br J Surg 103(5):504–512. https://doi.org/10.1002/bjs.10096
Mayo NE, Feldman L, Scott S et al (2011) Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery. Surgery 150(3):505–514. https://doi.org/10.1016/j.surg.2011.07.045
Wijeysundera DN, Pearse R, Shulman MA et al (2016) Measurement of Exercise Tolerance before Surgery (METS) study: a protocol for an international multicentre prospective cohort study of cardiopulmonary exercise testing prior to major non-cardiac surgery. BMJ Open 6(3):e010359. https://doi.org/10.1136/bmjopen-2015-010359
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Study conception and design: Billingsley; acquisition of data: Walcott-Sapp; analysis and interpretation of data: Billingsley and Walcott-Sapp; drafting of manuscript: Billingsley and Walcott-Sapp; critical revision of manuscript: Billingsley and Walcott-Sapp.
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Walcott-Sapp, S., Billingsley, K.G. Preoperative optimization for major hepatic resection. Langenbecks Arch Surg 403, 23–35 (2018). https://doi.org/10.1007/s00423-017-1638-x
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DOI: https://doi.org/10.1007/s00423-017-1638-x