The role of exercise-based prehabilitation in enhancing surgical outcomes for patients with digestive system cancers: a meta-analysis
Abstract Background Prehabilitation is a crucial component of tumor rehabilitation that attempts to improve patients’ preoperative health, although its efficacy in treating patients with cancers of the digestive system is still up for debate. Methods The records from PubMed (MEDLINE), Embase, Web of...
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2025-01-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-025-03626-3 |
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| author | Shasha Xu Rong Yin Haiou Zhu Yin Gong Jing Zhu Changxian Li Qin Xu |
| author_facet | Shasha Xu Rong Yin Haiou Zhu Yin Gong Jing Zhu Changxian Li Qin Xu |
| author_sort | Shasha Xu |
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| description | Abstract Background Prehabilitation is a crucial component of tumor rehabilitation that attempts to improve patients’ preoperative health, although its efficacy in treating patients with cancers of the digestive system is still up for debate. Methods The records from PubMed (MEDLINE), Embase, Web of Science, Cochrane Library, EBSCO, Scopus, CNKI and Wan fang database up to November 2024 were systematically searched. The Cochrane Collaboration tool was employed for evaluating the risk of bias in each study, and the PRISMA 2020 checklist provided by the EQUATOR network was utilized. Results Through quality analysis, 20 articles were included, involving 1719 patients. Although its effect on severe complications is still unknown, the prehabilitation significantly decreased overall postoperative complications when compared to standard care, with a risk ratio (RR) of 0.74 (95% CI: 0.65 to 0.84). Despite not shortening the postoperative hospital stay (MD: -0.13, 95% CI: -0.29 to 0.03), prehabilitation demonstrated notable improvements in the 6-minute walk distance (6MWD), with preoperative gains (MD: 25.87, 95% CI: 14.49 to 37.25) and sustained benefits at 4 weeks postoperatively (MD: 22.48, 95% CI: 7.85 to 37.12). However, no significant differences in 6MWD were observed at 6 or 8 weeks postoperatively. The average improvement in 6MWD from baseline to preoperative was 28.99 (95% CI: 10.89 to 47.08, P = 0.002), and from 4 weeks postoperative to baseline, it was 25.95 (95% CI: 6.84 to 45.07, P = 0.008), with no significant change at 8 weeks. The acceptance and completion rates of prehabilitation were commendably high at 61% (95% CI: 47–75%) and 90% (95% CI: 87–93%), respectively, alongside a relatively low dropout rate of 10% (95% CI: 7% to13%). Conclusions Prehabilitation reduces postoperative complications and improves short-term physical function in digestive surgery patients, with good patient acceptance; however, the long-term effects are unknown due to a lack of follow-up data. Registration It was registered with the International Prospective Register of Systematic Reviews (PROSPERO) with the identification code CRD42022361100. |
| format | Article |
| id | doaj-art-e18216f3ae3349a3a0c0f0eb4d0b3f09 |
| institution | Kabale University |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Gastroenterology |
| spelling | doaj-art-e18216f3ae3349a3a0c0f0eb4d0b3f092025-01-26T12:36:23ZengBMCBMC Gastroenterology1471-230X2025-01-0125111610.1186/s12876-025-03626-3The role of exercise-based prehabilitation in enhancing surgical outcomes for patients with digestive system cancers: a meta-analysisShasha Xu0Rong Yin1Haiou Zhu2Yin Gong3Jing Zhu4Changxian Li5Qin Xu6Department of Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical UniversityDepartment of Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical UniversityDepartment of Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical UniversityDepartment of Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical UniversityDepartment of Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical UniversityDepartment of Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical UniversityDepartment of Nursing School, Nanjing Medical UniversityAbstract Background Prehabilitation is a crucial component of tumor rehabilitation that attempts to improve patients’ preoperative health, although its efficacy in treating patients with cancers of the digestive system is still up for debate. Methods The records from PubMed (MEDLINE), Embase, Web of Science, Cochrane Library, EBSCO, Scopus, CNKI and Wan fang database up to November 2024 were systematically searched. The Cochrane Collaboration tool was employed for evaluating the risk of bias in each study, and the PRISMA 2020 checklist provided by the EQUATOR network was utilized. Results Through quality analysis, 20 articles were included, involving 1719 patients. Although its effect on severe complications is still unknown, the prehabilitation significantly decreased overall postoperative complications when compared to standard care, with a risk ratio (RR) of 0.74 (95% CI: 0.65 to 0.84). Despite not shortening the postoperative hospital stay (MD: -0.13, 95% CI: -0.29 to 0.03), prehabilitation demonstrated notable improvements in the 6-minute walk distance (6MWD), with preoperative gains (MD: 25.87, 95% CI: 14.49 to 37.25) and sustained benefits at 4 weeks postoperatively (MD: 22.48, 95% CI: 7.85 to 37.12). However, no significant differences in 6MWD were observed at 6 or 8 weeks postoperatively. The average improvement in 6MWD from baseline to preoperative was 28.99 (95% CI: 10.89 to 47.08, P = 0.002), and from 4 weeks postoperative to baseline, it was 25.95 (95% CI: 6.84 to 45.07, P = 0.008), with no significant change at 8 weeks. The acceptance and completion rates of prehabilitation were commendably high at 61% (95% CI: 47–75%) and 90% (95% CI: 87–93%), respectively, alongside a relatively low dropout rate of 10% (95% CI: 7% to13%). Conclusions Prehabilitation reduces postoperative complications and improves short-term physical function in digestive surgery patients, with good patient acceptance; however, the long-term effects are unknown due to a lack of follow-up data. Registration It was registered with the International Prospective Register of Systematic Reviews (PROSPERO) with the identification code CRD42022361100.https://doi.org/10.1186/s12876-025-03626-3PrehabilitationDigestive system cancerPhysical exerciseFunctional capacityComplications |
| spellingShingle | Shasha Xu Rong Yin Haiou Zhu Yin Gong Jing Zhu Changxian Li Qin Xu The role of exercise-based prehabilitation in enhancing surgical outcomes for patients with digestive system cancers: a meta-analysis BMC Gastroenterology Prehabilitation Digestive system cancer Physical exercise Functional capacity Complications |
| title | The role of exercise-based prehabilitation in enhancing surgical outcomes for patients with digestive system cancers: a meta-analysis |
| title_full | The role of exercise-based prehabilitation in enhancing surgical outcomes for patients with digestive system cancers: a meta-analysis |
| title_fullStr | The role of exercise-based prehabilitation in enhancing surgical outcomes for patients with digestive system cancers: a meta-analysis |
| title_full_unstemmed | The role of exercise-based prehabilitation in enhancing surgical outcomes for patients with digestive system cancers: a meta-analysis |
| title_short | The role of exercise-based prehabilitation in enhancing surgical outcomes for patients with digestive system cancers: a meta-analysis |
| title_sort | role of exercise based prehabilitation in enhancing surgical outcomes for patients with digestive system cancers a meta analysis |
| topic | Prehabilitation Digestive system cancer Physical exercise Functional capacity Complications |
| url | https://doi.org/10.1186/s12876-025-03626-3 |
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