Effect of Multimodal Prehabilitation on Reducing Postoperative Complications and Enhancing Functional Capacity...

Area of Science:

• Oncology
• Surgical Sciences
• Rehabilitation Medicine

Background:

• Colorectal surgery presents significant risks, including high morbidity and reduced functional capacity.
• Optimizing patient condition preoperatively can mitigate adverse surgical outcomes.

Purpose of the Study:

• To evaluate the efficacy of a multimodal prehabilitation program in reducing postoperative complications and enhancing functional recovery in colorectal cancer patients.

Main Methods:

• The PREHAB trial was an international, multicenter randomized clinical trial involving adult patients with nonmetastasized colorectal cancer.
• Participants were assigned to either a 4-week multimodal prehabilitation program or standard care.
• Prehabilitation included high-intensity exercise, nutritional support, psychological support, and smoking cessation.

Main Results:

• Severe complications (Comprehensive Complication Index score >20) were significantly lower in the prehabilitation group (17.1%) versus standard care (29.7%).
• Medical complications, such as respiratory issues, were also reduced in the prehabilitation group.
• While 6-minute walking distance did not significantly differ at 4 weeks postoperatively, other functional capacity parameters favored prehabilitation.

Conclusions:

• Multimodal prehabilitation before colorectal cancer surgery is beneficial, leading to fewer severe and medical complications.
• This prehabilitation strategy enhances postoperative recovery compared to standard care.
• The PREHAB trial provides evidence supporting prehabilitation as an effective intervention for colorectal cancer patients undergoing surgery.