Efficacy Evaluation of Multimodal Prehabilitation in Colorectal Cancer Surgery—A Meta‐Analysis Based on Randomized Controlled Trials

Objective To conduct a systematic evaluation of the influence of multimodal prehabilitation on postoperative complications, functional recovery, and psychological states in patients undergoing colorectal cancer surgery. Methods Comprehensive searches were carried out in databases including PubMed, Embase, Cochrane, and Web of Science, along with the references of the included studies. Randomized controlled trials (RCTs) meeting the criteria were screened. Two researchers independently extracted data and utilized the Cochrane risk‐of‐bias assessment tool to evaluate the quality of the studies. Meta‐analysis was performed using RevMan 5.3 software. Results Ultimately, 5 RCTs were included. The meta‐analysis indicated that the multimodal prehabilitation group demonstrated a tendency toward an advantage in the 6‐minute walk test (6MWT) at 4 weeks postsurgery. Nevertheless, the combined analysis exhibited a moderate level of heterogeneity ( p = 0.02), and the overall effect lacked statistical significance ( p = 0.05). Regarding the changes in the 6MWT at 4 weeks postsurgery compared to the baseline, the 6MWT at 8 weeks postsurgery, and its change relative to the baseline, although the prehabilitation group showed an advantageous trend, the differences were not significant, and significant heterogeneity was observed. In terms of complications, the prehabilitation group had a remarkable advantage (OR = 0.65, 95% CI: [0.44, 0.96], p = 0.03), and there was a low degree of heterogeneity among the studies (I 2 = 0). For indicators such as readmission within 30 days, mortality events, postoperative ICU admission, and hospital stay duration, most of the differences between the two groups were not obvious. The Hospital Anxiety and Depression Scale (HADS) scores at 4 weeks after surgery suggested that prehabilitation had limited effectiveness in improving patients’ psychological states. Conclusions Multimodal prehabilitation is advantageous in reducing the incidence of postoperative complications in patients undergoing colorectal cancer surgery. However, its efficacy in functional recovery and psychological state improvement remains uncertain. It is essential to conduct more high‐quality studies in the future to further validate these findings.