PhD defence David ten Cate

Keywords: Prehabilitation, Perioperative care, Oncological surgery implementation 

"Prehabilitation to enhance outcomes in surgery" 

This thesis investigates the role of prehabilitation in improving surgical outcomes, recovery, and healthcare efficiency in colorectal and other cancer surgeries. Observational and randomized studies showed that multimodal prehabilitation—combining exercise, nutrition, psychological support, and smoking cessation—significantly improves preoperative fitness, particularly in vulnerable patients, and accelerates postoperative recovery. Large-scale analyses demonstrated reductions in medical and surgical complications, shorter hospital stays, and lower readmission rates, with proven cost-effectiveness. High participation rates were achieved, though logistical barriers remain, especially for high-risk patients and short preoperative windows. Implementation studies in colorectal and lung cancer pathways confirmed feasibility, even within tight timeframes, and suggest that prehabilitation can enhance resilience before major surgery.

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