Effect of Prehabilitation for Patients with Frailty Undergoing Colorectal Cancer Surgery: A Systematic Review and Meta-analysis

Abstract

Review question / Objective: We performed a meta-analysis to assess the impact of prehabilitation before colorectal surgery on functional outcome and postoperative complications in patients with frailty. Condition being studied: Colorectal cancer is a common disease in the elderly, and over 65 years of age accounts for more than 50% of all patients with colorectal cancer. The patients with colorectal cancer surgery showed 8.7% major morbidity and mortality and 31.6% minor complications. The high complication rate of patients with colorectal surgery is related to the fact that there are many elderly patients. Frailty is common in elderly patients, and the frailty is associated with adverse perioperative outcomes. The frail patients with colorectal surgery showed worse postoperative morbidity, mortality and prolonged length of hospital stay. Although the frailty results from irresistible aging-associated decline in reserve and function across multiple physiologic systems, several attempts have been conducted to improve frailty in patients with colorectal cancer surgery and consequently improve the postoperative outcomes. Prehabilitation was one of these attempts for improving physical activity and postoperative outcomes on patients with frailty undergoing colorectal cancer surgery. So far, several studies conducted clinical trials for determining whether prehabilitation has positive effect on improving postoperative outcomes in patients with frailty undergoing colorectal surgery. However, the results of these previous studies are controversial.