Meta-analysis on impact of prehabilitation on clinical outcomes after surgery of patients with colorectal cancer
Objective To explore the effect of prehabilitation on the clinical outcomes after surgery of patients with colorectal cancer.Methods The PubMed,Embase,Cochrane Library,and Web of Science were searched to collect relevant literatures of the effects of prehabilitation for patients undergoing colorectal cancer surgery from their establishment to March,2023.Two reviewers independently evaluated the quality of the included studies.The RevMan 5.3 software was used for the meta-analysis of the total incidence of postoperative complications,time to first anal exhaust,incidences of gastrointestinal dysfunction,pneumonia,and anastomotic leakage,hospital stay,and mortality.Results A total of 13 articles with a sample size of 8 311 cases were enrolled,including 3 033 cases in the prehabilitation group and 5 278 cases in the control group.The meta-analysis results showed that the prehabilitation group had a lower incidence of postoperative complications(OR=0.55,95％CI 0.39-0.77,P＜0.05),shorter time to first anal exhaust(WMD=-0.70,95％CI-1.29 to-0.11,P＜0.05),and a lower incidence of gastrointestinal dysfunction(OR=0.53,95％CI 0.43-0.65,P＜0.05)than the control group.There were no statistical differences in the incidences of postoperative pneumonia and anastomotic leakage,hospital stay,and mortality between the two groups(all P＞0.05).Conclusion Prehabilitation can reduce the total incidence of postoperative complications in patients with colorectal cancer,shorten the time to first anal exhaust,decrease the incidence of gastrointestinal dysfunction,and improve their clinical outcomes.
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