{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:35:35Z","timestamp":1788863735794,"version":"build-2803163510"},"reference-count":66,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The growing strain on global healthcare systems, driven by aging populations, rising prevalence of chronic diseases, and workforce shortages, has increased interest in strategies that enhance perioperative outcomes and healthcare sustainability. From this perspective, prehabilitation\u2014a proactive, multimodal approach to enhance patients\u2019 functional, nutritional, and psychological status prior to surgery\u2014has gained attention as a potential contributor to value-based, personalized care. This study aims to synthesize mechanistic rationale, clinical evidence, and system-level considerations for prehabilitation, with particular focus on allostatic capacity and the body\u2019s response to surgical stress. Current evidence shows that prehabilitation may reduce postoperative complications, shorten hospital stays, and improve functional recovery, particularly when interventions are multimodal. However, the existing literature is characterized by methodological heterogeneity and variable quality, seemingly limiting generalizability and large-scale implementation. Further research is required to standardize outcome measures, identify patient subgroups most likely to benefit, and evaluate cost-effectiveness. Integration of prehabilitation into perioperative care pathways will depend on improved mechanistic understanding, robust clinical trials, and alignment with broader health policy and system-level initiatives. Prehabilitation may represent a meaningful step toward value-based and sustainable surgical care, though its implementation must be guided by high-quality evidence and careful consideration of context-specific factors.<\/jats:p>","DOI":"10.3390\/jcm14196747","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T13:16:11Z","timestamp":1758719771000},"page":"6747","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Prehabilitation: A Catalyst for Transforming Toward Value-Based, Personalized Perioperative Health and Care"],"prefix":"10.3390","volume":"14","author":[{"given":"Brenda H.","family":"van Koningsveld-Couperus","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thijs","family":"de Rooij","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico L.","family":"van Meeteren","sequence":"additional","affiliation":[{"name":"Top Sector Life Sciences & Health (Health~Holland), 2595 AN The Hague, The Netherlands"},{"name":"Department of Cardiothoragic Surgery, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands"},{"name":"Netherlands National Committee for the Protection of Animals Used for Scientific Purposes (NCad), 2500 EK The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4412-9183","authenticated-orcid":false,"given":"Benedikt","family":"Preckel","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8248-0244","authenticated-orcid":false,"given":"Markus W.","family":"Hollmann","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9874-2632","authenticated-orcid":false,"given":"Gertrude J.","family":"Nieuwenhuijs-Moeke","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"ref_1","unstructured":"(2025, May 10). Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/365133\/9789240064911-eng.pdf?sequence=1."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"516","DOI":"10.2471\/BLT.07.046474","article-title":"Forecasting the global shortage of physicians: An economic- and needs-based approach","volume":"86","author":"Scheffler","year":"2008","journal-title":"Bull. World Health Organ."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1016\/S0140-6736(18)31612-X","article-title":"The Lancet Commission on global mental health and sustainable development","volume":"392","author":"Patel","year":"2018","journal-title":"Lancet"},{"key":"ref_4","first-page":"112","article-title":"Operating Room Efficiency: Challenges and Solutions","volume":"31","author":"Kozanhan","year":"2021","journal-title":"J. Perioper. Pract."},{"key":"ref_5","first-page":"1721","article-title":"Frailty as a predictor of surgical outcomes in older patients","volume":"304","author":"Makary","year":"2010","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/S0140-6736(18)33139-8","article-title":"Global burden of postoperative death","volume":"393","author":"Nepogodiev","year":"2019","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1056\/NEJMsa0903048","article-title":"Variation in hospital mortality associated with inpatient surgery","volume":"361","author":"Ghaferi","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/S0140-6736(17)32152-9","article-title":"GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: A systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"Naghavi","year":"2017","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Dencker, E.E., Bonde, A., Troelsen, A., Varadarajan, K.M., and Sillesen, M. (2021). Postoperative complications: An observational study of trends in the United States from 2012 to 2018. BMC Surg., 21.","DOI":"10.1186\/s12893-021-01392-z"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1213\/ANE.0000000000002345","article-title":"Risk Stratification for Major Postoperative Complications in Patients Undergoing Intra-abdominal General Surgery Using Latent Class Analysis","volume":"126","author":"Kim","year":"2018","journal-title":"Anesth. Analg."},{"key":"ref_11","first-page":"100136","article-title":"Urgent need to take action on reducing postoperative respiratory complications","volume":"10","author":"Le","year":"2021","journal-title":"Lancet Reg. Health West. Pac."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1001\/jamasurg.2020.0091","article-title":"Association of Functional, Cognitive, and Psychological Measures with 1-Year Mortality in Patients Undergoing Major Surgery","volume":"155","author":"Tang","year":"2020","journal-title":"JAMA Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1016\/j.jamcollsurg.2004.05.280","article-title":"Functional independence after major abdominal surgery in the elderly","volume":"358","author":"Lawrence","year":"2004","journal-title":"J. Am. Coll. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1001\/jamasurg.2016.4952","article-title":"Enhanced Recovery After Surgery: A Review","volume":"152","author":"Ljungqvist","year":"2017","journal-title":"JAMA Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"znaf019","DOI":"10.1093\/bjs\/znaf019","article-title":"Routine anaesthesia ward-based patient visits in surgery: 1-year outcomes of the TRACE randomized clinical trial","volume":"112","author":"Boer","year":"2025","journal-title":"Br. J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.bjae.2020.04.006","article-title":"Anaesthesia, analgesia, and the surgical stress response","volume":"20","author":"Cusack","year":"2020","journal-title":"BJA Educ."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.bja.2019.08.011","article-title":"Redefining the perioperative stress response: A narrative review","volume":"123","author":"Korbonits","year":"2019","journal-title":"Br. J. Anaesth."},{"key":"ref_18","unstructured":"van Beijsterveld, C.A.F.M. (2020). Better Be Prepared: Transition in Perioperative Physical Therapy Care with Patients that Decided to Have Surgery Because of Cancer in the Pancreas or Liver. [Doctoral Thesis, Maastricht University]."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/ALN.0000000000000936","article-title":"Long-term Survival for Patients Undergoing Volatile versus IV Anesthesia for Cancer Surgery: A Retrospective Analysis","volume":"124","author":"Wigmore","year":"2016","journal-title":"Anesthesiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1016\/j.clnu.2015.08.005","article-title":"The impact of sarcopenia and myosteatosis on outcomes of unresectable pancreatic cancer or distal cholangiocarcinoma","volume":"35","author":"Rollins","year":"2016","journal-title":"Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.jtcvs.2004.05.020","article-title":"Intraoperative regional myocardial acidosis and reduction in long-term survival after cardiac surgery","volume":"129","author":"Khuri","year":"2005","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"103059","DOI":"10.1016\/j.amsu.2021.103059","article-title":"Prevention and management of perioperative hypothermia in adult elective surgical patients: A systematic review","volume":"72","author":"Simegn","year":"2021","journal-title":"Ann. Med. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"253","DOI":"10.5489\/cuaj.3725","article-title":"Back-to-back comparison of mini-open vs. laparoscopic technique for living kidney donation","volume":"10","author":"Rampersad","year":"2016","journal-title":"Can. Urol. Assoc. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e001943","DOI":"10.1136\/bmjopen-2012-001943","article-title":"Thirty-day complications after laparoscopic or open cholecystectomy: A population-based cohort study in Italy","volume":"3","author":"Agabiti","year":"2013","journal-title":"BMJ Open"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1097\/ACO.0000000000000989","article-title":"Immunomodulators in anesthesia","volume":"34","author":"Cruz","year":"2021","journal-title":"Curr. Opin. Anaesthesiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1159\/000482014","article-title":"A Review of Anesthetic Effects on Renal Function: Potential Organ Protection","volume":"46","author":"Motayagheni","year":"2017","journal-title":"Am. J. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s00540-011-1244-y","article-title":"Effects of sevoflurane and propofol on pulmonary inflammatory responses during lung resection","volume":"26","author":"Sugasawa","year":"2011","journal-title":"J. Anesth."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/ALN.0000000000000448","article-title":"Propofol Attenuated Acute Kidney Injury after Orthotopic Liver Transplantation via Inhibiting Gap Junction Composed of Connexin 32","volume":"122","author":"Luo","year":"2015","journal-title":"Anesthesiology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.3892\/etm.2013.1305","article-title":"Effects of propofol on renal ischemia\/reperfusion injury in rats","volume":"6","author":"Yang","year":"2013","journal-title":"Exp. Ther. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1159\/000430329","article-title":"Propofol Prevents Renal Ischemia-Reperfusion Injury via Inhibiting the Oxidative Stress Pathways","volume":"37","author":"Li","year":"2015","journal-title":"Cell. Physiol. Biochem."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1016\/j.athoracsur.2016.10.062","article-title":"Sevoflurane Attenuates Ischemia-Reperfusion Injury in a\u00a0Rat\u00a0Lung\u00a0Transplantation Model","volume":"103","author":"Ohsumi","year":"2017","journal-title":"Ann. Thorac. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1213\/ANE.0000000000005191","article-title":"Disease Mechanisms of Perioperative Organ Injury","volume":"131","author":"Conrad","year":"2020","journal-title":"Anesth. Analg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1097\/ALN.0000000000000887","article-title":"Patient-specific Immune States before Surgery Are Strong Correlates of Surgical Recovery","volume":"123","author":"Fragiadakis","year":"2015","journal-title":"Anesthesiology"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Laudanski, K. (2022). Quo Vadis Anesthesiologist? The Value Proposition of Future Anesthesiologists Lies in Preserving or Restoring Presurgical Health after Surgical Insult. J. Clin. Med., 11.","DOI":"10.3390\/jcm11041135"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Kallen, V., Tahir, M., Bedard, A., Bongers, B., Van Riel, N., and Van Meeteren, N. (2021). Aging and Allostasis: Using Bayesian Network Analytics to Explore and Evaluate Allostatic Markers in the Context of Aging. Diagnostics, 11.","DOI":"10.3390\/diagnostics11020157"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Beese, S., Postma, J., and Graves, J.M. (2022). Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood Research. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192417006"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1097\/PHM.0000000000001221","article-title":"Making Patients Fit for Surgery: Introducing a Four Pillar Multimodal Prehabilitation Program in Colorectal Cancer","volume":"98","author":"Molenaar","year":"2019","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.amjmed.2010.09.013","article-title":"Smoking cessation reduces postoperative complications: A systematic review and meta-analysis","volume":"124","author":"Mills","year":"2011","journal-title":"Am. J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1007\/s12630-011-9652-x","article-title":"Short-term preoperative smoking cessation and postoperative complications: A systematic review and meta-analysis","volume":"59","author":"Wong","year":"2011","journal-title":"Can. J. Anaesth."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1046\/j.1365-2168.1999.01181.x","article-title":"Preoperative alcoholism and postoperative morbidity","volume":"86","author":"Tonnesen","year":"1999","journal-title":"Br. J. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.bja.2017.10.020","article-title":"Perioperative cardiopulmonary exercise testing (CPET): Consensus clinical guidelines","volume":"120","author":"Levett","year":"2018","journal-title":"Br. J. Anaesth."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1097\/SLA.0b013e3181cf811d","article-title":"Submaximal Cardiopulmonary Exercise Testing Predicts Complications and Hospital Length of Stay in Patients Undergoing Major Elective Surgery","volume":"251","author":"Snowden","year":"2010","journal-title":"Ann. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1093\/bja\/aev454","article-title":"Role of cardiopulmonary exercise testing as a risk-assessment method in patients undergoing intra-abdominal surgery: A systematic review","volume":"116","author":"Moran","year":"2016","journal-title":"Br. J. Anaesth."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1093\/bjs\/znab292","article-title":"Relation between preoperative aerobic fitness estimated by steep ramp test performance and postoperative morbidity in colorectal cancer surgery","volume":"109","author":"Cuijpers","year":"2022","journal-title":"Br. J. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/jso.27201","article-title":"Steep ramp test protocol for preoperative risk assessment and short-term high-intensity interval training to evaluate, improve, and monitor cardiorespiratory fitness in surgical oncology","volume":"127","author":"Bongers","year":"2023","journal-title":"J. Surg. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1159\/000545181","article-title":"Prehabilitation and inflammation","volume":"81","author":"Kammerer","year":"2025","journal-title":"Ann. Nutr. Metab."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1113\/EP085318","article-title":"Skeletal muscle hypoxia-inducible factor-1 and exercise","volume":"101","author":"Lindholm","year":"2016","journal-title":"Exp. Physiol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Carrard, J., Gallart-Ayala, H., Weber, N., Colledge, F., Streese, L., Hanssen, H., Schmied, C., Ivanisevic, J., and Schmidt-Trucks\u00e4ss, A. (2021). How ceramides orchestrate cardiometabolic health\u2014An ode to physically active living. Metabolites, 11.","DOI":"10.3390\/metabo11100675"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1038\/nri3041","article-title":"The anti-inflammatory effects of exercise: Mechanisms and implications","volume":"11","author":"Gleeson","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Reidy, P., Mahmassani, Z., KcKenzie, A., Petrocelli, J., Summers, S., and Drummond, M. (2020). Influence of exercise training on skeletal muscle insulin resistance in aging. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21041514"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Brattinga, B., Rutgers, A., De Haan, J., Absalom, A., Van der Wal-Huisman, H., De Bock, G., and Van Leeuwen, B. (2021). Preoperative inflammatory markers as predictors of survival in older cancer patients. Cancers, 13.","DOI":"10.3390\/cancers13081824"},{"key":"ref_52","first-page":"142","article-title":"The effect of exercise on regulatory T cells: A systematic review","volume":"27","author":"Proschinger","year":"2021","journal-title":"Exerc. Immunol. Rev."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s40140-022-00516-2","article-title":"From Theory to Practice: An International Approach to Establishing Prehabilitation Programmes","volume":"12","author":"Davis","year":"2022","journal-title":"Curr. Anesthesiol. Rep."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1001\/jamasurg.2023.0198","article-title":"Effect of Multimodal Prehabilitation on Reducing Postoperative Complications and Enhancing Functional Capacity Following Colorectal Cancer Surgery: The PREHAB Randomized Clinical Trial","volume":"158","author":"Molenaar","year":"2023","journal-title":"JAMA Surg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e050806","DOI":"10.1136\/bmjopen-2021-050806","article-title":"Pre-admission interventions (prehabilitation) to improve outcome after major elective surgery: A systematic review and meta-analysis","volume":"11","author":"Perry","year":"2021","journal-title":"BMJ Open"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/PHM.0000000000002097","article-title":"Efficacy of Prehabilitation Before Cardiac Surgery: A Systematic Review and Meta-analysis","volume":"102","author":"Steinmetz","year":"2023","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.jviscsurg.2021.07.003","article-title":"Prehabilitation in hepato-pancreato-biliary surgery: A systematic review and meta-analysis","volume":"159","author":"Dagorno","year":"2022","journal-title":"J. Visc. Surg."},{"key":"ref_58","first-page":"CD013259","article-title":"Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery","volume":"5","author":"Molenaar","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.bja.2021.11.014","article-title":"Prehabilitation in adult patients undergoing surgery: An umbrella review of systematic reviews","volume":"128","author":"McIsaac","year":"2022","journal-title":"Br. J. Anaesth."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e081164","DOI":"10.1136\/bmj-2024-081164","article-title":"Relative efficacy of prehabilitation interventions and their components: Systematic review with network and component network meta-analyses of randomised controlled trials","volume":"388","author":"McIsaac","year":"2025","journal-title":"BMJ"},{"key":"ref_61","unstructured":"Nederlandse Vereniging voor Heelkunde (2025, May 10). Standpunt Prehabilitatie: Voorbereiding van Pati\u00ebnten Met Colorectaal Carcinoom op de Operatie. Available online: https:\/\/assets.heelkunde.nl\/p\/491520\/none\/Standpunt%20Prehabilitatie%20-%20definitief.pdf."},{"key":"ref_62","unstructured":"Nederlandse Vereniging voor Anesthesiologie (2025, May 10). Kennisagenda Anesthesiologie 2022. Available online: https:\/\/www.anesthesiologie.nl\/uploads\/files\/KENNISAGENDA_ANESTHESIOLOGIE_2022.pdf."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"7226","DOI":"10.1245\/s10434-023-14192-x","article-title":"Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study","volume":"30","author":"Raichurkar","year":"2023","journal-title":"Ann. Surg. Oncol."},{"key":"ref_64","unstructured":"Kennisinstituut van de Federatie Medisch Specialisten (2025, May 10). Financi\u00eble Impact van Aanbevelingen van Het Standpunt Prehabilitatie. Available online: https:\/\/assets.heelkunde.nl\/p\/491520\/none\/BIA%20Prehabilitatie%20-%20rapportage.pdf."},{"key":"ref_65","unstructured":"Rijksoverheid (2025, May 10). Integraal Zorgakkoord: \u2018Samen Werken aan Gezonde Zorg\u2019. Available online: https:\/\/www.rijksoverheid.nl\/documenten\/rapporten\/2022\/09\/16\/integraal-zorgakkoord-samen-werken-aan-gezonde-zorg."},{"key":"ref_66","unstructured":"Zorginstituut Nederland (2025, May 10). Multimodale Prehabilitatie v\u00f3\u00f3r een Operatie bij Hoogrisicopati\u00ebnten Met Darmkanker. Available online: https:\/\/www.zorginstituutnederland.nl\/publicaties\/standpunten\/2024\/02\/13\/standpunt-multimodale-prehabilitatie."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/6747\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:49:03Z","timestamp":1760035743000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/6747"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,24]]},"references-count":66,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["jcm14196747"],"URL":"https:\/\/doi.org\/10.3390\/jcm14196747","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,24]]}}}