LB110 - CLINICAL APPLICATION AND ASSOCIATION BETWEEN BIOIMPEDANCE ANALYSIS AND FUNCTIONAL STATUS IN PRE-OPERATIVE CANCER PREHABILITATION

LB110

CLINICAL APPLICATION AND ASSOCIATION BETWEEN BIOIMPEDANCE ANALYSIS AND FUNCTIONAL STATUS IN PRE-OPERATIVE CANCER PREHABILITATION

R. M. Shariff^1,*, M. S. Jahit¹

¹Department of Surgery, National Cancer Institute, Kuala Lumpur, Malaysia

Rationale: Prehabilitation is a standard practice before major abdominal surgery, especially for cancer patients with severe malnutrition and physical function impairments due to cancer cachexia. These patients require 10 - 14 days of nutritional and functional prehabilitation. The effectiveness of prehabilitation in preparing patients adequately has been debated. This study examines the relevance and association of bioimpedance analysis and functional status in assessing prehabilitation adequacy before major abdominal surgery.   

Methods: This prospective observational review will examine 32 patients undergoing prehabilitation and scheduled major abdominal surgery from January to May 2025. Prehabilitation includes correcting refeeding syndrome, implementing a nutritional care plan, and providing aerobic and resistance exercises. Bioimpedance analysis will be monitored at baseline and post-intervention before proceeding with elective surgery.. Paired t-tests and Pearson correlation analyses were conducted with significance set at p<0.05.

Results: Post-intervention analyses revealed significant improvements in functional parameters including handgrip strength (22.6±6.73 to 25.5±7.87kg, p=0.004) and two-minute walk test distance (96.8±41.12 to 120.2±57.18m, p=0.003). While body composition parameters including SMI (5.9±1.19 to 6.0±1.37kg/m², p=0.826), phase angle (4.2±1.02 to 4.1±0.90°, p=0.430), and ECW (0.39±0.009 to 0.39±0.011, p=0.372) demonstrated non-significant changes. Strong correlations were observed between SMI and handgrip strength at baseline (r=0.71, p<0.001) and post-intervention (r=0.67, p<0.001). Phase angle demonstrated strong positive correlation with both handgrip strength (r=0.72, p<0.001) and two-minute walk test (r=0.57, p=0.001) post-intervention.

Conclusion: Functional improvements precede detectable changes in bioimpedance parameters during short-term prehabilitation. Strong correlations between bioimpedance values and functional metrics validate phase angle and SMI as valuable monitoring markers. The unchanged phase angle and ECW likely reflect the underlying irreversible cellular alterations and disrupted fluid homeostasis intrinsic to cancer cachexia, suggesting limitations of short-term prehabilitation in reversing these fundamental pathophysiological changes before major oncological surgery.

References: Carli, F., Charlebois, P., Stein, B., Feldman, L., Zavorsky, G., Kim, D. J., Scott, S., & Mayo, N. E. (2010). Randomized clinical trial of prehabilitation in colorectal surgery. British Journal of Surgery, 97(8), 1187-1197.

Norman, K., Stobäus, N., Pirlich, M., & Bosy-Westphal, A. (2012). Bioelectrical phase angle and impedance vector analysis – clinical relevance and applicability of impedance parameters. Clinical Nutrition, 31(6), 854-861.

Disclosure of Interest: None declared