Effects of perioperative exercise therapy on cardiorespiratory fitness and postoperative complications in patients with colorectal cancer: a systematic review and meta-analysis

Purpose Improving cardiorespiratory fitness (CRF) before and after colorectal cancer surgery may improve postoperative outcomes. This systematic review and meta-analysis evaluated the effects of perioperative exercise therapy (aerobic, resistance, mind–body, flexibility, or mixed exercise (combined aerobic and resistance)) on CRF, the ventilatory anaerobic threshold (VAT), postoperative complications, and adverse events for patients diagnosed with colorectal cancer undergoing surgery. Methods Eligible published randomised controlled trials (RCTs) were identified from an electronic database search (inception—31 May 2020 and updated 16 April 2024). Databases included PubMed, CINAHL, SPORTDiscus, Cochrane Library (CENTRAL), and Web of Science. Pooled standardised mean differences ( SMD ) with 95% confidence intervals ( CI ) were compared, and heterogeneity was assessed using Cochran’s Q and I 2 statistics. Results Twenty-five eligible trials (1385 participants) were included in the meta-analysis. Perioperative exercise demonstrated significant improvements in CRF ( SMD = 0.28, 95% CI = 0.17, 0.38; p < 0.05) and the VAT ( SMD = 0.43, 95% CI = 0.23, 0.63; p < 0.05) when compared to usual care. No noticeable differences in postoperative complications or adverse events between the groups were found. Conclusions Perioperative exercise delivered before and after colorectal cancer surgery significantly improves CRF and the VAT.