Effects and duration of exercise-based prehabilitation in surgical therapy of colon and rectal cancer: a systematic review and meta-analysis
Open accessAbstract
Purpose: Functional capacity is an independent indicator of morbidity in colon and rectal cancer surgery. This systematic review describes the evaluated and synthesized effects of exercise prehabilitation depending on the duration of interventions on functional and postoperative outcomes in colon and rectal cancer surgery. Methods: Three electronic databases (MEDLINE Pubmed, Web of Sciences, and Cochrane Registry) were systematically searched (January 2022) for controlled trials that investigated the effects of prehabilitation prior to colo-rectal cancer resection. Results: Twenty-three studies were included in this systematic review and 14 in our meta-analyses assessing these outcomes: the 6 min walk distance (6MWD), postoperative overall complications, and length of stay (LOS). We observed a significant improvement in preoperative functional capacity as measured with 6MWD (mean difference: 30.8 m; 95% CI 13.3, 48.3; p = 0.0005) due to prehabilitation. No reductions in LOS (mean difference: – 0.27 days; 95% CI – 0.93, 0.40; p = 0.5) or postoperative overall complications (Odds ratio: 0.84; 95% CI 0.53, 1.31; p = 0.44) were observed. Prehabilitation lasting more than 3 weeks tended to lower overall complications (Odds ratio: 0.66; 95% CI 0.4, 1.1; p = 0.11). However, the prehabilitation time periods differed between colon and rectal carcinoma resections. Conclusion: Prehabilitation while the patient is preparing to undergo surgery for colorectal carcinoma improves functional capacity; and might reduce postoperative overall complications, but does not shorten the LOS. The studies we reviewed differ in target variables, design, and the intervention’s time period. Multicenter studies with sufficient statistical power and differentiating between colon and rectal carcinoma are needed to develop implementation strategies in the health care system. Registration: PROSPERO CRD42022310532
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Reviews typically estimate one effect for either a single prehabilitation component or pool heterogeneous interventions together.
“Reviews typically estimate one effect for either a single prehabilitation component (eg, exercise only) or pool heterogeneous interventions together.1 14 17 18”
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- Authors
- Falz, R., Bischoff, C., Thieme, R., Lässing, J., Mehdorn, M., Stelzner, S., Busse, M., & Gockel, I.
- Affiliations
- Leipzig University (DE)
- University Hospital Leipzig (DE)
- Corresponding author
- Falz, Roberto
- ORCID
- Venue
- Journal of Cancer Research and Clinical Oncology
- Published
- 2022-06-13
- Volume
- 148
- Issue
- 9
- Pages
- 2187-2213
- ISSN
- 0084-5353 (ISSN-L)
- 0171-5216
- 1432-1335
- PMC
- PMC9349170
- OpenAlex
- W4282547680
- Cited by
- 104
- References
- 80
- Citations by year
- 2026: 11 · 2025: 33 · 2024: 35 · 2023: 21 · 2022: 4
- FWCI
- 5.52
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Cancer Research and Clinical Oncology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, cc-by)
- Funders
- Universität Leipzig
- Topics
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Keywords
- exercise prehabilitation, colon cancer surgery, rectal cancer surgery, colorectal cancer surgery, 6-minute walk distance, postoperative complications, length of hospital stay, intervention duration
- MeSH terms
- Preoperative Exercise, Carcinoma, Humans, Postoperative Complications, Preoperative Care, Rectal Neoplasms, Colorectal Neoplasms
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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