SP7.13 Effect of prehabilitation in patients undergoing esophageal or gastric cancer resections: a systematic review and meta-analysis

Introduction The objective of this article is to evaluate the effectiveness of prehabilitation versus no-prehabilitation in patients undergoing esophageal or gastric 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 esophageal or gastric 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 10 studies were included (n=968), recruiting adult patients undergoing esophageal or gastric cancer resections. In the random effect model analysis, prehabilitation was associated with fewer postoperative complications compared to no-prehabilitation (Risk ratio [RR]: 0.65; 95% confidence interval [CI] [0.47, 0.90], z = 2.62, P = 0.009). Additionally, prehabilitation was associated with a lower postoperative readmission rate compared to no-prehabilitation (RR: 0.59; 95% CI [0.35, 0.98], z = 2.03, P = 0.04). Prehabilitation was also found to improve the preoperative 6-minute walk test (6-MWT) compared to no-prehabilitation (Standard mean difference [SMD]]: 0.79; 95% CI [0.14, 1.44], z = 2.39, P = 0.02). No statistical difference was found in postoperative 6-MWD (SMD: 0.64; 95% CI [-0.18, 1.46], z = 1.53, P = 0.13), postoperative mortality (RR: 1.17; 95% CI [0.65, 2.12], z = 0.53, P = 0.60), or length of stay (SMD: -0.12; 95% CI [-0.36, 0.11], z = 1.03, P = 0.3). Conclusions Prehabilitation effectively reduced postoperative morbidity and improved preoperative physical health in patients undergoing esophageal or gastric cancer resections.