预康复对胃肠道择期手术患者术后恢复效果的系统评价
方芳, 台瑞, 余倩, 章雅青

Effect of prehabilitation on outcomes in patients undergoing elective gastrointestinal surgery: a systematic review
FANG Fang, TAI Rui, YU Qian, ZHANG Yaqing
表1 纳入研究的基本信息
Tab 1 Basic information of the selected studies
StudyPopulation

Sample size

(I/C)

Intervention methodControl methodFollow-upOutcome
LÓPEZ-RODRÍGUEZ-ARIAS, 202111Adults, elective surgery for colon or rectal neoplasm10/10A 30-d trimodal prehabilitation program with recommendations on physical exercise, nutritional supplementation, and relaxation exercises to be performed at home before surgery and the first 30 d after hospital dischargeStandard care12 weeks postoper-ative①②⑥
BARBERAN-GARCIA, 201812Adults, elective major abdominal surgery with high risk62/63A personalized prehabilitation program based on their health conditions and social circumstances which encompassed 3 major steps: motivational interview to assess the patients′ adherence profile and to codesign the characteristics of the physical activity program with the patient; personalized program to promote daily physical activity; supervised high-intensity endurance exercise training programStandard careBefore discharge

①②③

④⑤⑥

BOUSQUET-DION, 201813Adults, elective surgery for colon or rectal neoplasm37/26A 4-week multi-modal home-based exercise program with once-weekly supervision consisted of exercise intervention, nutritional intervention and anxiety-reduction strategiesStandard care8 weeks postoper-ative

①②③

④⑥⑦

OMMUNDSEN, 201814>65 years, elective colorectal cancer surgery and fulfilling predefined criteria for frailty53/63A 3-week pragmatic tailored intervention based on the results of the geriatric assessmentStandard care3 months postoper-ative

①②⑤

BURDEN, 201715Adults, elective colorectal cancer surgery with preoperative weight loss>1 kg per 3‒6 months55/45Oral supplementation (10.1 KJ, 0.096 g of protein per mL) at a dose of 250 mL daily for a minimum of 5 d before the operationBottled water30 days postoper-ative

①②⑥

GILLIS, 201616Adults, elective surgery for colon or rectal neoplasm22/21A whey protein supplement was provided in a quantity that matched the patient′s need according to the estimated deficit in dietary protein intake for approximately 4 weeks leading up to the surgeryPlacebo4 weeks postoper-ative③⑥
GILLIS, 201417Adults, elective surgery for colon or rectal neoplasm38/39A 4-week trimodal prehabilitation program at home included exercise intervention, nutrition intervention, and coping strategies to reduce anxietyStandard care8 weeks postoper-ative

①③④

FUJITANI, 201218≤80 years, elective total gastrectomy, body weight loss of 10 percent or less within 6 months before entry127/117Preoperative oral supplementation of 1 000 mL/d in the form of an immunonutrient-enriched enteral feed added to normal diet for 5 d consecutively before the surgeryNormal dietBefore discharge①②⑥
BURDEN, 201119Adults, elective surgery for colon or rectal neoplasm54/62Oral supplementary drink of 400 mL daily, and dietary advice for 10 d before the operationDietary advice onlyBefore discharge①②⑥
SMEDLEY, 200420Adults, elective moderate to severe lower gastrointestinal surgery48/50Oral nutritional supplement in small, frequent quantities between meals for 7 d before the operation, the volume consumed was recordedNormal dietBefore discharge

①②⑥

GIANOTTI, 200221Adults, major elective surgery for malignancy of the gastrointestinal tract102/102Oral nutritional supplement (1 000 mL/d) of a formula enriched with arginine, ω-3 fatty acids, and RNA for 5 d before the operationStandard care30 d after discharge

①②⑤

BRAGA, 200222Adults, elective surgery for gastroin-testinal neoplasm, body weight loss of 10% or more within 6 months before entry50/50Oral nutritional supplement (1 000 mL/d) added to normal diet for 7 d consecutively before the surgeryNormal diet30 d after discharge

①②⑤

KABATA, 201523Adults, elective, radical gastroin-testinal and abdominal cancer surgery54/48Oral nutritional supplement (400 mL/d) added to normal diet for 14 d consecutively before the surgeryNormal diet30 d postoper-ative①⑤⑥
BARKER, 201324Adults, elective upper and lower gastrointestinal surgery46/49Three packs of 237 mL of oral nutritional supplement per day for 5 d before the surgeryStandard care30 d postoper-ative

①②⑤

BERKEL, 202225≥60 years, elective surgery for colon or rectal neoplasm28/29A personalized 3-week (3 sessions per week, 9 sessions in total) supervised exercise programStandard care90 d postoper-ative①②⑥
HUANG, 201426Adults, elective, radical gastroin-testinal, cancer surgery41/41Oral nutritional supplement (25 mL/kg) for 7 d before the surgeryNormal dietBefore discharge①②⑥