Zhang Xiaoting, Wang Shaokang, Ji Wentao, Wang Huixian, Zhou Keqian, Jin Zhichao, Bo Lulong
Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai, China.
Front Oncol. 2022 Jul 29;12:958261. doi: 10.3389/fonc.2022.958261. eCollection 2022.
Prehabilitation is analogous to marathon training and includes preoperative preparation for exercise, as well as nutrition and psychology. However, evidence-based recommendations to guide prehabilitation before colorectal surgery are limited. We aimed to evaluate the effect of prehabilitation on the postoperative outcomes of patients undergoing colorectal surgery.
This study is a systematic review and meta-analysis.
The PubMed, Embase, and Cochrane databases were searched for studies reporting the effect of prehabilitation strategies versus standard care or rehabilitation in patients undergoing colorectal surgery. The primary outcomes were overall postoperative complications and length of hospital stay (LOS), and the secondary outcome was functional capacity (measured using the 6-min walk test [6MWT]) at 4 and 8 weeks after surgery.
Fifteen studies with 1,306 participants were included in this meta-analysis. The results showed no significant reduction in the number of overall postoperative complications (risk ratio = 1.02; 95% confidence interval [CI] = 0.79-1.31; = 0.878) or LOS (standardized mean difference = 0.04; 95% CI = -0.11 to 0.20; = 0.589) in patients who underwent colorectal surgery with or without prehabilitation strategy. Additionally, there were no significant differences in the functional capacity estimated using the 6MWT at 4 and 8 weeks postoperatively.
Prehabilitation did not significantly affect the number of postoperative complications, LOS, or functional capacity of patients undergoing colorectal surgery. Whether prehabilitation should be recommended deserves further consideration.
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=290108, identifier CRD42021290108.
术前康复类似于马拉松训练，包括术前运动准备以及营养和心理方面的准备。然而，指导结直肠手术前进行术前康复的循证建议有限。我们旨在评估术前康复对接受结直肠手术患者术后结局的影响。
本研究为系统评价和荟萃分析。
检索PubMed、Embase和Cochrane数据库，查找报告术前康复策略与标准护理或康复对接受结直肠手术患者影响的研究。主要结局为术后总体并发症和住院时间（LOS），次要结局为术后4周和8周时的功能能力（采用6分钟步行试验[6MWT]测量）。
本荟萃分析纳入了15项研究，共1306名参与者。结果显示，无论是否采用术前康复策略，接受结直肠手术的患者术后总体并发症数量（风险比=1.02；95%置信区间[CI]=0.79-1.31；P=0.878）或住院时间（标准化均数差=0.04；95%CI=-0.11至0.20；P=0.589）均无显著减少。此外，术后4周和8周时采用6MWT评估的功能能力也无显著差异。
术前康复对接受结直肠手术患者的术后并发症数量、住院时间或功能能力无显著影响。是否推荐术前康复值得进一步考虑。
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=290108，标识符CRD42021290108 。
