Shining the way with hopes

NTWC Cardiopulmonary Exercise Testing and Prehabilitation Team
New Territories West Cluster

In 2019, New Territories West Cluster established Hong Kong’s first Preoperative Cardiopulmonary Testing (CPEX) services, providing objective risk assessments and individualised preoperative risk modification programmes to high-risk surgical patients. “Even if surgery is technically feasible, high medical risks make surgeons hesitate,” the Team explains. “This led us to think what we can do to make a difference for these patients, such that they can have a choice to undergo the intended operation.”

Over the past three years, the Team has brought together experts in anaesthesia, medicine & rehabilitation, surgery, physiotherapy, occupational therapy, and dietetics to provide individualised preoperative risk assessments for more than 600 patients, modifying their risk profiles through early cardiopulmonary prehabilitation with a combination of medical optimisation, physical and respiratory training. “Many of these patients are diagnosed with cancer and the treatment is time critical,” the Team says. “We provide assessment and training as early as the time when cancer is suspected, so that patients can be trained up and ready for surgery as soon as the diagnosis is confirmed. What’s more, the risks of postoperative complications can be mitigated. Having the trust and engagement of the patients and their families, patients could learn the skills and importance of prehabilitation. It further benefits postoperative rehabilitation, which, in turn, shortens the length of stay.”

Each specialty possesses expertise in different perspectives, so the Team discusses complex clinical situations through interdisciplinary collaborations. Given the complementary strengths and infinite creativity, a treatment plan is developed. “The Team is dedicated to achieving an optimal physical health of patients and, with teamwork, enabling patients to undergo surgery to prolong their lives. Turn impossible into possible, we are all touched and motivated by the changes we have witnessed,” the Team members recall.

In order to benefit more patients, the Team keeps sharing their experience with colleagues in other clusters, helping set up perioperative service models. In future, CPEX and Prehabilitation Team hopes to engage more specialties such as clinical psychology to provide preoperative psychological counselling and support to patients and their families in a holistic approach.

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