We want to share this Cochrane review: Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery.
Objectives: To determine the effects of multimodal prehabilitation programmes on functional capacity, postoperative complications, and quality of life in adult patients undergoing surgery for colorectal cancer.
Main results: Three randomized trials with 250 participants were included.
Participants in the interventional group were enrolled in a preoperative four‐week trimodal prehabilitation programme consisting of exercise, nutritional intervention, and anxiety reduction techniques. Their outcomes were compared to participants who received the same programme postoperatively.
For all outcomes, the certainty of evidence was considered moderate to very low low. The main reasons for downgrading were high risk of bias, inconcistency, and imprecision.
- Prehabilitation may improve functional capacity, determined with the 6‐minute walk test at four and eight weeks (mean difference (MD) 26.02, 95% confidence interval (CI) ‐13.81 to 65.85; 2 studies; n = 131; and MD 26.58, 95% CI ‐8.88 to 62.04; 2 studies; n = 140); however, the certainty of evidence is low and very low, respectively, due to serious risk of bias, imprecision, and inconsistency.
- After prehabilitation, the functional capacity before surgery improved, with a clinically relevant mean difference of 24.91 metres (95% CI 11.24 to 38.57; 3 studies; n = 225). The certainty of evidence was moderate due to downgrading for serious risk of bias.
- The effects of prehabilitation on the number of complications (RR 0.95, 95% CI 0.70 to 1.29; 3 studies; n = 250), emergency department visits (RR 0.72, 95% CI 0.39 to 1.32; 3 studies; n = 250) and re‐admissions (RR 1.20, 95% CI 0.54 to 2.65; 3 studies; n = 250) were small or even trivial.
Authors' conclusion: Prehabilitation may result in an improved functional capacity, determined with the 6‐minute walk test both preoperatively and postoperatively. A solid effect on the number of complications, postoperative emergency department visits and re‐admissions could not be established.
Access publication here: https://doi.org/10.1002/14651858.CD013259.pub3
