Meta-analysis on impact of prehabilitation on clinical outcomes after surgery of patients with colorectal cancer

doi:10.3760/cma.j.issn.1007-1245.2024.03.004

Abstract

Abstract:

Objective　To explore the effect of prehabilitation on the clinical outcomes after surgery of patients with colorectal cancer. Methods　The PubMed, Embase, Cochrane Library, and Web of Science were searched to collect relevant literatures of the effects of prehabilitation for patients undergoing colorectal cancer surgery from their establishment to March, 2023. Two reviewers independently evaluated the quality of the included studies. The RevMan 5.3 software was used for the meta-analysis of the total incidence of postoperative complications, time to first anal exhaust, incidences of gastrointestinal dysfunction, pneumonia, and anastomotic leakage, hospital stay, and mortality. Results　A total of 13 articles with a sample size of 8 311 cases were enrolled, including 3 033 cases in the prehabilitation group and 5 278 cases in the control group. The meta-analysis results showed that the prehabilitation group had a lower incidence of postoperative complications (OR=0.55, 95%CI 0.39-0.77, P<0.05), shorter time to first anal exhaust (WMD=-0.70, 95%CI -1.29 to -0.11, P<0.05), and a lower incidence of gastrointestinal dysfunction (OR=0.53, 95%CI 0.43-0.65, P<0.05) than the control group. There were no statistical differences in the incidences of postoperative pneumonia and anastomotic leakage, hospital stay, and mortality between the two groups (all P>0.05). Conclusion　Prehabilitation can reduce the total incidence of postoperative complications in patients with colorectal cancer, shorten the time to first anal exhaust, decrease the incidence of gastrointestinal dysfunction, and improve their clinical outcomes.

Key words:

Colorectal cancer, Prehabilitation, Colorectal surgery, Postoperative complications, Meta-analysis

摘要：

目的　探讨预康复对结直肠癌患者术后临床结局的影响。方法　检索PubMed、Embase、Cochrane Library、Web of Science数据库，检索时限从各数据库建库至2023年3月。收集预康复对结直肠癌手术患者影响的相关文献，由2名研究者对纳入文献独立进行质量评价。采用RevMan5.3软件对术后总并发症发生率，首次肛门排气时间，胃肠功能障碍、肺炎、术后吻合口瘘发生率，住院时间及病死率等指标进行分析。结果　纳入文献共13篇，总样本量为8 311例，其中预康复组3 033例，对照组5 278例。meta分析结果显示，预康复组术后总并发症发生率低于对照组（OR=0.55，95%CI 0.39～0.77，P<0.05），术后首次肛门排气时间短于对照组（WMD=-0.70，95%CI -1.29～-0.11，P<0.05），胃肠功能障碍发生率低于对照组（OR=0.53，95%CI 0.43～0.65，P<0.05）；两组患者术后肺炎和吻合口瘘发生率、住院时间及病死率差异均无统计学意义（均P>0.05）。结论　预康复可降低结直肠癌患者术后总并发症发生率，缩短术后首次肛门排气时间及减少胃肠功能障碍的发生，有助于改善患者临床结局。

关键词:

结直肠癌, 预康复, 结直肠外科, 术后并发症, meta分析

Zhang Kaisi, Ma Jindong, Zhang Qihui, Chen Qiangpu.

Meta-analysis on impact of prehabilitation on clinical outcomes after surgery of patients with colorectal cancer [J]. International Medicine and Health Guidance News, 2024, 30(3): 367-373.

张凯思马金栋张启慧陈强谱.

预康复干预对结直肠癌患者术后临床结局影响的meta分析 [J]. 国际医药卫生导报, 2024, 30(3): 367-373.

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