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Postoperative outcomes after prehabilitation for colorectal cancer patients undergoing surgery: a systematic review and meta-analysis of randomized and nonrandomized studies. | LitMetric

AI Article Synopsis

  • The systematic review aimed to compare short-term postoperative outcomes for colorectal cancer patients undergoing a prehabilitation program versus standard care before surgery.
  • A total of seven studies involving 1,042 patients were analyzed, but no significant differences were found in postoperative complications, hospital stays, or readmission rates between the two groups.
  • The conclusion suggests that while prehabilitation does not seem to enhance short-term outcomes, the evidence is limited, indicating the need for larger-scale trials to assess its long-term effects.

Article Abstract

Purpose: Prehabilitation (PH) is purported to improve patients' preoperative functional status. This systematic review and meta-analysis sought to compare short-term postoperative outcomes between patients who underwent a protocolized PH program and the existing standard of care among colorectal cancer patients awaiting surgery.

Methods: A search in MEDLINE/PubMed, the Cochrane Library, Embase, Scopus, and CINAHL was conducted to identify relevant articles. Repetitive and exhaustive combinations of MeSH search terms ("prehabilitation," "colorectal cancer," "colon cancer," and "rectal cancer") were used to identify randomized and nonrandomized studies comparing PH versus standard of care for colorectal cancer patients awaiting surgery. The primary outcomes included postoperative morbidity, length of hospital stay, and readmission rates.

Results: Seven studies including 1,042 colorectal cancer patients (PH, 382) were included. No significant differences were found in intraoperative outcomes. The postoperative complication rates were comparable between groups (Clavien-Dindo grades I and II: risk ratio, 0.82; 95% confidence interval, 0.62-1.07; P=0.15; Clavien-Dindo grades ≥III: risk ratio, 1.02; 95% confidence interval, 0.72-1.44; P=0.92). There were also no significant differences in length of hospital stay (P=0.21) or the risk of 30-day readmission (P=0.68).

Conclusion: Although PH does not appear to improve short-term postoperative outcomes following colorectal cancer surgery, the quality of evidence is impaired by the limited trials and heterogeneity. Thus, further large-scale trials are warranted to draw definitive conclusions and establish the long-term effects of PH.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362756PMC
http://dx.doi.org/10.3393/ac.2022.01095.0156DOI Listing

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