Effect of Multimodal Prehabilitation on Functional Capacity and Postoperative Complications in Gastrointestinal Cancer Surgery

Résumé fourni par la source

OBJECTIVE: This study evaluated multimodal perioperative prehabilitation-combining exercise, nutrition, and psychological interventions-on functional capacity (6MWT distance, reflecting cardiopulmonary fitness) and clinical outcomes (postoperative complications, hospital stay, mortality, and readmission rates) in gastrointestinal cancer surgery. METHODS: We conducted a systematic review and meta-analysis of 12 prospective trials (n=1229) identified via the PubMed, Web of Science, Cochrane Library, and Embase databases from their inception to March 20, 2025. Heterogeneity was evaluated with I2 and Q tests; random- or fixed-effects models were applied. RESULTS: Multimodal prehabilitation significantly improved the 6MWT preoperatively [mean difference (MD): 30.1 m; 95% CI: 14.8-45.4] and at 4 weeks (MD: 21.5 m; 95% CI: 14.1-28.9) and 8 weeks postoperatively (MD: 38.7 m; 95% CI: 1.9-75.4). It was associated with a 0.86-day (95% CI: -1.43 to -0.30) shorter hospital stay and lowered overall [risk ratio (RR) 0.67; 95% CI: 0.57-0.79] and severe complications (RR: 0.77; 95% CI: 0.61-0.97), with no effect on operative time, mortality, or readmission. CONCLUSIONS: This study shows that patients receiving multimodal prehabilitation achieve better functional recovery (6MWT) and fewer complications, supporting its integration into perioperative care.

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