Journal of Shanghai Jiao Tong University (Medical Science) >

2023 , Vol. 43 >Issue 1: 70 - 78

DOI: https://doi.org/10.3969/j.issn.1674-8115.2023.01.009

Evidence-based medicine

Effect of prehabilitation on outcomes in patients undergoing elective gastrointestinal surgery: a systematic review

  • Fang FANG ,
  • Rui TAI ,
  • Qian YU ,
  • Yaqing ZHANG
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  • 1.Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
    2.Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China
ZHANG Yaqing, E-mail: zhangyqf@163.com.

Received date: 2022-09-22

  Accepted date: 2022-12-27

  Online published: 2023-01-28

Supported by

Three-year Action Plan for Strengthening Public Health System in Shanghai (GWV-5);Nursing Development Program of Shanghai Jiao Tong University School of Medicine;Clinical Research Innovation Plan of Shanghai General Hospital(CTCCR-2021C08)

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Abstract

Objective ·To systematically evaluate the effect of prehabilitation on outcomes in patients undergoing elective gastrointestinal surgery. Methods ·PubMed, EMbase, Cochrane Library, Web of Science, CINAHL, Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang and VIP Database were searched systematically from the establishment of each database to January 31, 2022. The literatures were screened, and evaluated according to the preset inclusion and exclusion criteria. The literature quality was evaluated and the data were extracted. Meta-analysis was performed on randomized controlled trials by using RevMan 5.4. The main observation indexes were the postoperative complication rate and the incidence of surgical site infection. The secondary indexes were hospitalization days, 6-minute walk test (6MWT), Hospital Anxiety and Depression Scale (HADS) score, mortality and compliance of prerehabilitation execution. Results ·Sixteen articles were included, including 15 articles in English and 1 article in Chinese, with a total of 1 616 patients. The overall quality of the included researches was good. The meta-analysis results showed that compared with the control group, the incidences of postoperative complications and surgical site infection were reduced [(odds ratio, OR)=0.57, 95% (confidence interval, CI)0.35?0.94, P=0.030; OR=0.64, 95%CI 0.46?0.90, P=0.009]; the length of hospital stay was shortened [mean difference (MD)=-2.45, 95%CI -3.17 ? -1.73, P=0.000] in the experimental group after the implementation of prehabilitation. There was no significant difference in preoperative 6MWT level between the two groups. Compared with the baseline, the change of 6MWT level before operation of the experimental group was bigger than that of the control group (MD=24.19, 95%CI 3.77?44.60, P=0.020). There were no significant differences in the preoperative HADS score and the postoperative mortality between the two groups. Conclusion ·Prehabilitation can reduce the incidence of postoperative complications, especially surgical site infection, in patients undergoing elective gastrointestinal surgery, thus shortening the length of hospital stay and promoting the recovery of patients.

Key words： gastrointestinal surgery; prehabilitation; postoperative recovery; systematic review; meta-analysis

Cite this article

Fang FANG , Rui TAI , Qian YU , Yaqing ZHANG . Effect of prehabilitation on outcomes in patients undergoing elective gastrointestinal surgery: a systematic review[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023 , 43(1) : 70 -78 . DOI: 10.3969/j.issn.1674-8115.2023.01.009

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