Meta-analysis of impact of prehabilitation on outcomes of major abdominal surgery for cancer

Prehabilitation is increasingly used to optimize perioperative outcomes. Meta-analysis of 27 randomized controlled trials (published through 2023) comparing prehabilitation with usual care among 2532 patients undergoing major abdominal surgery for cancer, investigated the impact of prehabilitation on outcomes. Prehabilitation was associated with improved preoperative functional capacity (mean difference in 6-minute walking distance 28.32 meters; p<0.01) and lower odds of postoperative complications (OR 0.60; pxtagstartz0.01) but not with odds of emergency readmission (OR 0.90; p=0.61) or length of stay (mean difference -0.42 days; p=0.15). Multimodal versus unimodal prehabilitation was associated with greater improvement in functional capacity (6MWD 37.35 meters versus 13.38 meters) and lower odds of postoperative complications (OR 0.61; p<0.01 versus OR 0.63; p=0.10). The authors conclude that prehabilitation improves functional capacity and reduces postoperative complications among surgical oncology patients undergoing major abdominal surgery.