Prehabilitation Outcomes in Surgical Oncology Patients Undergoing Major Abdominal Surgery: A Meta-analysis of Randomized Control Trials
Background Prehabilitation has been increasingly utilized to optimize perioperative outcomes. In this study, we aim to evaluate the impact of uni- and multimodal prehabilitation on functional capacity and postoperative outcomes among surgical oncology patients undergoing major abdominal surgery. Pat...
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| Veröffentlicht in: | Annals of surgical oncology 2025-02, Vol.32 (2), p.1236-1247 |
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| container_title | Annals of surgical oncology |
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| creator | Soh, Natalie Hann Yau, Charles Rong Zhang Low, Xi Zhi Kadir, Hanis Abdul Fong, Wei Jing Ramalingam, Mothi Babu Tan, Pei Ling Ng, Kennedy Yao Yi Hsing, Ya Ting Cai, Mingzhe Seo, Chin Jin Ong, Johnny Chin-Ann Chia, Claramae S. Wong, Jolene Si Min |
| description | Background
Prehabilitation has been increasingly utilized to optimize perioperative outcomes. In this study, we aim to evaluate the impact of uni- and multimodal prehabilitation on functional capacity and postoperative outcomes among surgical oncology patients undergoing major abdominal surgery.
Patients and Methods
Three electronic databases (PubMed, Embase, Cochrane) were systematically searched up until December 2023. We included randomized controlled trials comparing prehabilitation to standard of care in surgical oncology patients undergoing major abdominal surgery. Our primary outcome was functional capacity as measured by the 6-min walk distance (6MWD). Secondary outcomes include postoperative complications, emergency readmissions, and length of stay (LOS). We stratified our findings to determine the impact of uni- versus multimodal prehabilitation on outcomes.
Results
We included 27 studies with 2532 surgical oncology patients. Overall, patients undergoing prehabilitation demonstrated a significant improvement in preoperative functional capacity compared to those without prehabilitation (mean difference in 6MWD 28.32 meters [m], 95% CI 15.26, 41.39,
p
< 0.01). Prehabilitation was also associated with significantly lower odds of postoperative complications (odds ratio [OR] 0.60, 95% CI 0.46, 0.78,
p
< 0.01). There was no difference in emergency readmission (OR 0.90, 95% CI 0.59, 1.38,
p
= 0.61) or LOS (mean difference −0.42 days, 95% CI −1.01, 0.16,
p
= 0.15). Comparing uni- versus multimodal prehabilitation, multimodal prehabilitation was associated with greater improvements in functional capacity (6MWD 37.35 m versus 13.38 m) and lower odds of postoperative complications (OR 0.61, 95% CI 0.45, 0.82,
p
< 0.01 versus OR 0.63, 95% CI 0.36, 1.11,
p
= 0.10)
Conclusion
Prehabilitation improves functional capacity and reduces postoperative complications among surgical oncology patients undergoing major abdominal surgery. |
| doi_str_mv | 10.1245/s10434-024-16527-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3140893809</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3140893809</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-4337279564618d0a5c061a8be8d3d458bf3691aac93eedba600807c3810526d93</originalsourceid><addsrcrecordid>eNp9kctuFDEQRS1ERELgB1ggS2zYNCk_281uNOIlJZoIkrXltj2DR912sLsXww_w27iZQKQsWFWpfO4tuS5Crwi8I5SLi0KAM94A5Q2RgraNeoLOiKgjLhV5WnuQqumoFKfoeSl7ANIyEM_QKeskkbQTZ-jXdfbfTR-GMJkppIg382TT6AsOEX-b8y5YM-BNtGlIuwO-rpCPU8G30fm8SyHu8JXZp4xXvUtjiBVeVD4f3uMVvvKTaUwdHkooOG3xVxMX7Kd3eJ3ilNOAb3IwQ3mBTra1-Jf39Rzdfvxws_7cXG4-fVmvLhtLhZwazlhL205ILolyYIQFSYzqvXLMcaH6LZMdMcZ2zHvXGwmgoLVMERBUuo6do7dH37ucfsy-THoMxfphMNGnuWhGOKiOKVjQN4_QfZpz_cxCCcKgJS2vFD1SNqdSst_quxxGkw-agF5i0seYdI1J_4lJqyp6fW8996N3_yR_c6kAOwKlPsV6zofd_7H9DSBDnfs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3151307174</pqid></control><display><type>article</type><title>Prehabilitation Outcomes in Surgical Oncology Patients Undergoing Major Abdominal Surgery: A Meta-analysis of Randomized Control Trials</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Soh, Natalie Hann ; Yau, Charles Rong Zhang ; Low, Xi Zhi ; Kadir, Hanis Abdul ; Fong, Wei Jing ; Ramalingam, Mothi Babu ; Tan, Pei Ling ; Ng, Kennedy Yao Yi ; Hsing, Ya Ting ; Cai, Mingzhe ; Seo, Chin Jin ; Ong, Johnny Chin-Ann ; Chia, Claramae S. ; Wong, Jolene Si Min</creator><creatorcontrib>Soh, Natalie Hann ; Yau, Charles Rong Zhang ; Low, Xi Zhi ; Kadir, Hanis Abdul ; Fong, Wei Jing ; Ramalingam, Mothi Babu ; Tan, Pei Ling ; Ng, Kennedy Yao Yi ; Hsing, Ya Ting ; Cai, Mingzhe ; Seo, Chin Jin ; Ong, Johnny Chin-Ann ; Chia, Claramae S. ; Wong, Jolene Si Min</creatorcontrib><description>Background
Prehabilitation has been increasingly utilized to optimize perioperative outcomes. In this study, we aim to evaluate the impact of uni- and multimodal prehabilitation on functional capacity and postoperative outcomes among surgical oncology patients undergoing major abdominal surgery.
Patients and Methods
Three electronic databases (PubMed, Embase, Cochrane) were systematically searched up until December 2023. We included randomized controlled trials comparing prehabilitation to standard of care in surgical oncology patients undergoing major abdominal surgery. Our primary outcome was functional capacity as measured by the 6-min walk distance (6MWD). Secondary outcomes include postoperative complications, emergency readmissions, and length of stay (LOS). We stratified our findings to determine the impact of uni- versus multimodal prehabilitation on outcomes.
Results
We included 27 studies with 2532 surgical oncology patients. Overall, patients undergoing prehabilitation demonstrated a significant improvement in preoperative functional capacity compared to those without prehabilitation (mean difference in 6MWD 28.32 meters [m], 95% CI 15.26, 41.39,
p
< 0.01). Prehabilitation was also associated with significantly lower odds of postoperative complications (odds ratio [OR] 0.60, 95% CI 0.46, 0.78,
p
< 0.01). There was no difference in emergency readmission (OR 0.90, 95% CI 0.59, 1.38,
p
= 0.61) or LOS (mean difference −0.42 days, 95% CI −1.01, 0.16,
p
= 0.15). Comparing uni- versus multimodal prehabilitation, multimodal prehabilitation was associated with greater improvements in functional capacity (6MWD 37.35 m versus 13.38 m) and lower odds of postoperative complications (OR 0.61, 95% CI 0.45, 0.82,
p
< 0.01 versus OR 0.63, 95% CI 0.36, 1.11,
p
= 0.10)
Conclusion
Prehabilitation improves functional capacity and reduces postoperative complications among surgical oncology patients undergoing major abdominal surgery.</description><identifier>ISSN: 1068-9265</identifier><identifier>ISSN: 1534-4681</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-024-16527-8</identifier><identifier>PMID: 39616295</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdomen ; Abdomen - surgery ; Abdominal surgery ; Clinical trials ; Complications ; Gastrointestinal Oncology ; Humans ; Length of Stay - statistics & numerical data ; Medicine ; Medicine & Public Health ; Neoplasms - rehabilitation ; Neoplasms - surgery ; Oncology ; Postoperative ; Postoperative Complications - prevention & control ; Preoperative Care ; Preoperative Exercise ; Prognosis ; Randomized Controlled Trials as Topic ; Surgery ; Surgical Oncology ; Treatment Outcome</subject><ispartof>Annals of surgical oncology, 2025-02, Vol.32 (2), p.1236-1247</ispartof><rights>Society of Surgical Oncology 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. Society of Surgical Oncology.</rights><rights>Copyright Springer Nature B.V. Feb 2025</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-4337279564618d0a5c061a8be8d3d458bf3691aac93eedba600807c3810526d93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-024-16527-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-024-16527-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39616295$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soh, Natalie Hann</creatorcontrib><creatorcontrib>Yau, Charles Rong Zhang</creatorcontrib><creatorcontrib>Low, Xi Zhi</creatorcontrib><creatorcontrib>Kadir, Hanis Abdul</creatorcontrib><creatorcontrib>Fong, Wei Jing</creatorcontrib><creatorcontrib>Ramalingam, Mothi Babu</creatorcontrib><creatorcontrib>Tan, Pei Ling</creatorcontrib><creatorcontrib>Ng, Kennedy Yao Yi</creatorcontrib><creatorcontrib>Hsing, Ya Ting</creatorcontrib><creatorcontrib>Cai, Mingzhe</creatorcontrib><creatorcontrib>Seo, Chin Jin</creatorcontrib><creatorcontrib>Ong, Johnny Chin-Ann</creatorcontrib><creatorcontrib>Chia, Claramae S.</creatorcontrib><creatorcontrib>Wong, Jolene Si Min</creatorcontrib><title>Prehabilitation Outcomes in Surgical Oncology Patients Undergoing Major Abdominal Surgery: A Meta-analysis of Randomized Control Trials</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Prehabilitation has been increasingly utilized to optimize perioperative outcomes. In this study, we aim to evaluate the impact of uni- and multimodal prehabilitation on functional capacity and postoperative outcomes among surgical oncology patients undergoing major abdominal surgery.
Patients and Methods
Three electronic databases (PubMed, Embase, Cochrane) were systematically searched up until December 2023. We included randomized controlled trials comparing prehabilitation to standard of care in surgical oncology patients undergoing major abdominal surgery. Our primary outcome was functional capacity as measured by the 6-min walk distance (6MWD). Secondary outcomes include postoperative complications, emergency readmissions, and length of stay (LOS). We stratified our findings to determine the impact of uni- versus multimodal prehabilitation on outcomes.
Results
We included 27 studies with 2532 surgical oncology patients. Overall, patients undergoing prehabilitation demonstrated a significant improvement in preoperative functional capacity compared to those without prehabilitation (mean difference in 6MWD 28.32 meters [m], 95% CI 15.26, 41.39,
p
< 0.01). Prehabilitation was also associated with significantly lower odds of postoperative complications (odds ratio [OR] 0.60, 95% CI 0.46, 0.78,
p
< 0.01). There was no difference in emergency readmission (OR 0.90, 95% CI 0.59, 1.38,
p
= 0.61) or LOS (mean difference −0.42 days, 95% CI −1.01, 0.16,
p
= 0.15). Comparing uni- versus multimodal prehabilitation, multimodal prehabilitation was associated with greater improvements in functional capacity (6MWD 37.35 m versus 13.38 m) and lower odds of postoperative complications (OR 0.61, 95% CI 0.45, 0.82,
p
< 0.01 versus OR 0.63, 95% CI 0.36, 1.11,
p
= 0.10)
Conclusion
Prehabilitation improves functional capacity and reduces postoperative complications among surgical oncology patients undergoing major abdominal surgery.</description><subject>Abdomen</subject><subject>Abdomen - surgery</subject><subject>Abdominal surgery</subject><subject>Clinical trials</subject><subject>Complications</subject><subject>Gastrointestinal Oncology</subject><subject>Humans</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasms - rehabilitation</subject><subject>Neoplasms - surgery</subject><subject>Oncology</subject><subject>Postoperative</subject><subject>Postoperative Complications - prevention & control</subject><subject>Preoperative Care</subject><subject>Preoperative Exercise</subject><subject>Prognosis</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Treatment Outcome</subject><issn>1068-9265</issn><issn>1534-4681</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctuFDEQRS1ERELgB1ggS2zYNCk_281uNOIlJZoIkrXltj2DR912sLsXww_w27iZQKQsWFWpfO4tuS5Crwi8I5SLi0KAM94A5Q2RgraNeoLOiKgjLhV5WnuQqumoFKfoeSl7ANIyEM_QKeskkbQTZ-jXdfbfTR-GMJkppIg382TT6AsOEX-b8y5YM-BNtGlIuwO-rpCPU8G30fm8SyHu8JXZp4xXvUtjiBVeVD4f3uMVvvKTaUwdHkooOG3xVxMX7Kd3eJ3ilNOAb3IwQ3mBTra1-Jf39Rzdfvxws_7cXG4-fVmvLhtLhZwazlhL205ILolyYIQFSYzqvXLMcaH6LZMdMcZ2zHvXGwmgoLVMERBUuo6do7dH37ucfsy-THoMxfphMNGnuWhGOKiOKVjQN4_QfZpz_cxCCcKgJS2vFD1SNqdSst_quxxGkw-agF5i0seYdI1J_4lJqyp6fW8996N3_yR_c6kAOwKlPsV6zofd_7H9DSBDnfs</recordid><startdate>20250201</startdate><enddate>20250201</enddate><creator>Soh, Natalie Hann</creator><creator>Yau, Charles Rong Zhang</creator><creator>Low, Xi Zhi</creator><creator>Kadir, Hanis Abdul</creator><creator>Fong, Wei Jing</creator><creator>Ramalingam, Mothi Babu</creator><creator>Tan, Pei Ling</creator><creator>Ng, Kennedy Yao Yi</creator><creator>Hsing, Ya Ting</creator><creator>Cai, Mingzhe</creator><creator>Seo, Chin Jin</creator><creator>Ong, Johnny Chin-Ann</creator><creator>Chia, Claramae S.</creator><creator>Wong, Jolene Si Min</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20250201</creationdate><title>Prehabilitation Outcomes in Surgical Oncology Patients Undergoing Major Abdominal Surgery: A Meta-analysis of Randomized Control Trials</title><author>Soh, Natalie Hann ; Yau, Charles Rong Zhang ; Low, Xi Zhi ; Kadir, Hanis Abdul ; Fong, Wei Jing ; Ramalingam, Mothi Babu ; Tan, Pei Ling ; Ng, Kennedy Yao Yi ; Hsing, Ya Ting ; Cai, Mingzhe ; Seo, Chin Jin ; Ong, Johnny Chin-Ann ; Chia, Claramae S. ; Wong, Jolene Si Min</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-4337279564618d0a5c061a8be8d3d458bf3691aac93eedba600807c3810526d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Abdomen</topic><topic>Abdomen - surgery</topic><topic>Abdominal surgery</topic><topic>Clinical trials</topic><topic>Complications</topic><topic>Gastrointestinal Oncology</topic><topic>Humans</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasms - rehabilitation</topic><topic>Neoplasms - surgery</topic><topic>Oncology</topic><topic>Postoperative</topic><topic>Postoperative Complications - prevention & control</topic><topic>Preoperative Care</topic><topic>Preoperative Exercise</topic><topic>Prognosis</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soh, Natalie Hann</creatorcontrib><creatorcontrib>Yau, Charles Rong Zhang</creatorcontrib><creatorcontrib>Low, Xi Zhi</creatorcontrib><creatorcontrib>Kadir, Hanis Abdul</creatorcontrib><creatorcontrib>Fong, Wei Jing</creatorcontrib><creatorcontrib>Ramalingam, Mothi Babu</creatorcontrib><creatorcontrib>Tan, Pei Ling</creatorcontrib><creatorcontrib>Ng, Kennedy Yao Yi</creatorcontrib><creatorcontrib>Hsing, Ya Ting</creatorcontrib><creatorcontrib>Cai, Mingzhe</creatorcontrib><creatorcontrib>Seo, Chin Jin</creatorcontrib><creatorcontrib>Ong, Johnny Chin-Ann</creatorcontrib><creatorcontrib>Chia, Claramae S.</creatorcontrib><creatorcontrib>Wong, Jolene Si Min</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soh, Natalie Hann</au><au>Yau, Charles Rong Zhang</au><au>Low, Xi Zhi</au><au>Kadir, Hanis Abdul</au><au>Fong, Wei Jing</au><au>Ramalingam, Mothi Babu</au><au>Tan, Pei Ling</au><au>Ng, Kennedy Yao Yi</au><au>Hsing, Ya Ting</au><au>Cai, Mingzhe</au><au>Seo, Chin Jin</au><au>Ong, Johnny Chin-Ann</au><au>Chia, Claramae S.</au><au>Wong, Jolene Si Min</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prehabilitation Outcomes in Surgical Oncology Patients Undergoing Major Abdominal Surgery: A Meta-analysis of Randomized Control Trials</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2025-02-01</date><risdate>2025</risdate><volume>32</volume><issue>2</issue><spage>1236</spage><epage>1247</epage><pages>1236-1247</pages><issn>1068-9265</issn><issn>1534-4681</issn><eissn>1534-4681</eissn><abstract>Background
Prehabilitation has been increasingly utilized to optimize perioperative outcomes. In this study, we aim to evaluate the impact of uni- and multimodal prehabilitation on functional capacity and postoperative outcomes among surgical oncology patients undergoing major abdominal surgery.
Patients and Methods
Three electronic databases (PubMed, Embase, Cochrane) were systematically searched up until December 2023. We included randomized controlled trials comparing prehabilitation to standard of care in surgical oncology patients undergoing major abdominal surgery. Our primary outcome was functional capacity as measured by the 6-min walk distance (6MWD). Secondary outcomes include postoperative complications, emergency readmissions, and length of stay (LOS). We stratified our findings to determine the impact of uni- versus multimodal prehabilitation on outcomes.
Results
We included 27 studies with 2532 surgical oncology patients. Overall, patients undergoing prehabilitation demonstrated a significant improvement in preoperative functional capacity compared to those without prehabilitation (mean difference in 6MWD 28.32 meters [m], 95% CI 15.26, 41.39,
p
< 0.01). Prehabilitation was also associated with significantly lower odds of postoperative complications (odds ratio [OR] 0.60, 95% CI 0.46, 0.78,
p
< 0.01). There was no difference in emergency readmission (OR 0.90, 95% CI 0.59, 1.38,
p
= 0.61) or LOS (mean difference −0.42 days, 95% CI −1.01, 0.16,
p
= 0.15). Comparing uni- versus multimodal prehabilitation, multimodal prehabilitation was associated with greater improvements in functional capacity (6MWD 37.35 m versus 13.38 m) and lower odds of postoperative complications (OR 0.61, 95% CI 0.45, 0.82,
p
< 0.01 versus OR 0.63, 95% CI 0.36, 1.11,
p
= 0.10)
Conclusion
Prehabilitation improves functional capacity and reduces postoperative complications among surgical oncology patients undergoing major abdominal surgery.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>39616295</pmid><doi>10.1245/s10434-024-16527-8</doi><tpages>12</tpages></addata></record> |
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| ispartof | Annals of surgical oncology, 2025-02, Vol.32 (2), p.1236-1247 |
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| subjects | Abdomen Abdomen - surgery Abdominal surgery Clinical trials Complications Gastrointestinal Oncology Humans Length of Stay - statistics & numerical data Medicine Medicine & Public Health Neoplasms - rehabilitation Neoplasms - surgery Oncology Postoperative Postoperative Complications - prevention & control Preoperative Care Preoperative Exercise Prognosis Randomized Controlled Trials as Topic Surgery Surgical Oncology Treatment Outcome |
| title | Prehabilitation Outcomes in Surgical Oncology Patients Undergoing Major Abdominal Surgery: A Meta-analysis of Randomized Control Trials |
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