MTP5.04 A meta-analysis reviewing the role of prehabilitation in patients undergoing hepatobiliary and pancreatic cancer resections

Introduction The objective of this article is to evaluate the effectiveness of prehabilitation versus no-prehabilitation in hepatobiliary and pancreatic cancer resections. Methods Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomized, controlled trials comparing prehabilitation versus no-prehabilitation before hepatic, biliary or pancreatic cancer resections. All data were analyzed using Review Manager Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results A total of 8 studies were included (n=736), recruiting adult patients undergoing hepatic, biliary or pancreatic cancer resections. In the random effect model analysis, prehabilitation was associated with fewer postoperative complications compared to no-prehabilitation (risk ratio [RR]: 0.75; 95% confidence interval [CI] [0.59, 0.97], z = 2.21, P = 0.03). No statistical difference was found in postoperative readmission rate (RR: 1.33; CI [0.75, 2.35], z = 0.96, P = 0.34) or major complications (RR: 1.06; CI [0.82, 1.38], z = 0.44, P = 0.66). Conclusions Multimodal prehabilitation was found to be effective in reducing the postoperative complications and improving quality of life in patients undergoing hepatobiliary and pancreatic cancer resections.