Abstract：
Epidemiological evidence has highlighted a strong relationship between cardiorespiratory fitness and surgical outcomes; specifically, fitter patients possess heightened resilience to withstand the surgical stress response. This narrative review draws on exercise and surgical physiology research to discuss and hypothesise the potential mechanisms by which higher fitness affords perioperative benefit. A higher fitness, as indicated by higher peak rate of oxygen consumption and ability to sustain metabolic homeostasis (i.e. higher anaerobic threshold) is beneficial postoperatively when metabolic demands are increased. However, the associated adaptations with higher fitness, and the related participation in regular exercise or physical activity, might also underpin the observed perioperative benefit through a process of hormesis, a protective adaptive response to the moderate and intermittent stress of exercise. Potential mediators discussed include greater antioxidant capacity, metabolic flexibility, glycaemic control, lean body mass, and improved mood.
摘要：
流行病学证据强调了心肺适应性和手术结果之间的密切关系；特别是，更适合的患者具有更高的弹性来承受手术应激反应。这篇叙述性综述借鉴了运动和手术生理学研究，讨论和假设了更高的适应性提供围手术期益处的潜在机制。更高的健身，如更高的峰值耗氧率和维持代谢稳态的能力(即更高的无氧阈值)所表明的,当代谢需求增加时,术后是有益的。然而,与更高的适应性相关的适应，以及相关的定期锻炼或体育活动的参与，也可能通过兴奋的过程来支持观察到的围手术期益处，对中等和间歇性运动压力的保护性适应性反应。讨论的潜在介质包括更大的抗氧化能力，代谢灵活性，血糖控制，瘦体重,和改善情绪。
