MTP6.03 Effect of multimodal prehabilitation in patients undergoing colorectal resections: a systematic review and meta-analysis

Introduction The objective of this article is to evaluate the effectiveness of multimodal prehabilitation versus no-prehabilitation in patients undergoing colorectal resections. Methods Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomized, controlled trials comparing multimodal prehabilitation versus no-prehabilitation before colorectal 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 14 studies were included (n=1530 participants), recruiting adult patients undergoing either laparoscopic or laparotomic colorectal resections. In the random effect model analysis, multimodal prehabilitation was associated with fewer postoperative complications compared to no-prehabilitation (Risk ratio [RR]: 0.82; 95% confidence interval [CI] [0.68, 1.00], z = 2.01, P = 0.04). No statistical difference was found in preoperative 6-minute walking distance (6-MWD) (Standard mean difference [SMD]: 0.53; 95% CI [-0.00, 1.06], z = 1.95, P = 0.05), postoperative 6-MWD (SMD: 0.23; 95% CI [-0.19, 0.65], z = 1.07, P = 0.28), postoperative mortality (RR: 0.40; 95% CI [0.08, 2.05], z = 1.10, P = 0.27), postoperative readmission rate (RR: 1.09; 95% CI [0.55, 2.13], z = 0.24, P = 0.81) or length of stay (SMD: -0.20; 95% CI [-0.44, 0.05], z = 1.56, P = 0.12). Conclusions Multimodal prehabilitation was found to be effective in reducing the postoperative morbidity in patients undergoing colorectal resections.