Institute for Lifecourse Development, Centre for Exercise Activity and Rehabilitation, School of Human Science, University of Greenwich, Sparrows Farm (Office SF112B), Sparrows Lane, Avery Hill Campus, Eltham, SE9 2TB, England, UK.
QuestPrehab, London, UK.
Support Care Cancer. 2024 Sep 17;32(10):667. doi: 10.1007/s00520-024-08875-8.
To investigate the effects of prehabilitation on the perioperative functional capacity of patients awaiting oncological resections.
A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist and within the databases Cochrane Library, EBSCOhost, Google Scholar, MEDLINE PubMed, and Web of Science. The eligibility criteria were set to include peer-reviewed randomised control trials including only adult (≥ 18 years old) patients undergoing any type of prehabilitation (PREHAB) prior to any type of oncological resection. The studies had to feature at least one control group undergoing standard care (SC) and had to assess functional capacity by means of a 6-min walk distance (6MWD) or peak oxygen uptake (VO) at different stages pre- and post- operatively.
Twenty-seven randomised controlled trials involving 1994 patients were included. After processing the data, the number of patients was 1889. Studies featured different cancer specialties: lung (11), colorectal (5), urological (4), abdominal (3), esophagogastric (2), liver (1), and gastrointestinal (1). Overall, PREHAB enhanced both 6MWD (g = 0.273, 95% CI 0.174 to 0.371, Z = 5.406, p < 0.001) and VO (g = 0.615, 95% CI 0.243 to 0.987, Z = 3.240, p = 0.001) compared with SC. The 6MWD subgroup analysis revealed a small mean effect size favouring both unimodal and multimodal PREHAB interventions.
These findings support that prehabilitation, whether implemented as unimodal or multimodal format, elicits small preoperative improvements in functional capacity in patients awaiting oncological resections. PROSPERO registration number CRD42023428676.
研究术前康复对接受肿瘤切除术患者围手术期功能能力的影响。
根据系统评价和荟萃分析的首选报告项目（PRISMA）检查表，并在 Cochrane 图书馆、EBSCOhost、Google Scholar、MEDLINE PubMed 和 Web of Science 数据库中进行了系统评价和荟萃分析。纳入标准为仅纳入接受任何类型术前康复（PREHAB）的成年（≥18 岁）患者的同行评审随机对照试验。这些研究必须至少有一组对照组接受标准护理（SC），并通过术前和术后不同阶段的 6 分钟步行距离（6MWD）或峰值摄氧量（VO）评估功能能力。
共纳入 27 项随机对照试验，涉及 1994 名患者。处理数据后，患者人数为 1889 人。研究涉及不同的癌症专科：肺（11）、结直肠（5）、泌尿（4）、腹部（3）、食管胃（2）、肝（1）和胃肠（1）。总体而言，与 SC 相比，PREHAB 可提高 6MWD（g=0.273，95%CI 0.174 至 0.371，Z=5.406，p<0.001）和 VO（g=0.615，95%CI 0.243 至 0.987，Z=3.240，p=0.001）。6MWD 亚组分析显示，两种单模态和多模态 PREHAB 干预均有利于产生较小的平均效应量。
这些发现支持术前康复，无论是采用单模态还是多模态形式，都能在接受肿瘤切除术的患者中术前改善功能能力。PROSPERO 注册号 CRD42023428676。
