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Impact of Multidisciplinary Prehabilitation Interventions on Postoperative Hospital Length of Stay and Functional Capacity in Patients Undergoing Resection of Colorectal Cancer: A Systematic Review and Meta-analysis

Marmol-Perez, Andres, Corres, Pablo, Fernández-Escabias, Manuel, Carrilho-Candeias, Sofia, Ruiz, Jonatan R., Amaro-Gahete, Francisco J., Carneiro-Barrera, Almudena·2024·Diseases of the Colon & Rectum
DOI 10.1097/dcr.0000000000003268
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Abstract

BACKGROUND: Although surgery is commonly regarded as the primary curative treatment for colorectal cancer, it could potentially be associated with postoperative morbidity and mortality. OBJECTIVE: To determine the pooled effect of exercise and multidisciplinary prehabilitation interventions on postoperative hospital length of stay and functional capacity in patients undergoing resection of colorectal cancer. DATA SOURCES: A systematic search was conducted in MEDLINE (via PubMed) and Web of Science databases from inception to November 2022. STUDY SELECTION: The original systematic search retrieved 2005 studies. After the removal of duplicates and screening by title and abstract, 77 eligible full-text documents were evaluated for final inclusion in the meta-analysis. A total of 12 randomized controlled trials, 5 nonrandomized controlled trials, and 3 uncontrolled before-and-after studies were selected. MAIN OUTCOME MEASURES: Postoperative hospital length of stay (in days) and functional capacity (assessed with the peak of oxygen consumption [VO 2 peak] and 6-minute walking test) were the outcome measures. RESULTS: The meta-analysis was conducted on 20 studies (3805 participants). Randomized controlled trials and nonrandomized controlled trials showed significant reductions in postoperative hospital length of stay (d = –0.10, nearly 2 days) and significant incremental improvements in VO 2 peak (d = 0.27) and 6-minute walking test (d = 0.31). Regarding the before-and-after studies, the pooled effect of multidisciplinary prehabilitation interventions was positively significant for VO 2 peak (d = 0.29) and 6-minute walking test (d = 0.29). There was no risk of publication bias (Egger test: p > 0.05), with a score of 0.71 (0–1) on average. LIMITATIONS: There was a high between-studies heterogeneity, and several outcomes did not have the required number of studies for a desirable statistical power. CONCLUSIONS: These findings suggest that multidisciplinary prehabilitation interventions might be effective at decreasing postoperative hospital length of stay (nearly 2 days) and improving functional capacity. REGISTRATION: PROSPERO registration number CRD42022373982.

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Metadata

Authors
Marmol-Perez, A., Corres, P., Fernández-Escabias, M., Carrilho-Candeias, S., Ruiz, J. R., Amaro-Gahete, F. J., & Carneiro-Barrera, A.
Venue
Diseases of the Colon & Rectum
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2024-08-07
Volume
67
Issue
9
Pages
1107-1119
ISSN
  • 0012-3706
  • 1530-0358
DOI
10.1097/dcr.0000000000003268
Cited by
20
References
6
Language
en
Funders
  • Spanish Ministry of Education, Culture and Sport (FPU20/05530)
  • Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea (CB22/03/00058)

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