Effectiveness of multimodal prehabilitation in patients with esophageal neoplasm： a meta-analysis of RCTs

Abstract

Objective To evaluate the effectiveness of multimodal prehabilitation among patients with esophageal neoplasm through meta-analysis. Methods Randomized controlled trials （RCTs） reporting the effectiveness of multimodal prehabilitation in patients with esophageal neoplasm were searched from PubMed， Embase， Cochrane Library， Web of Science， CNKI， Wanfang， Chongqing VIP and CBM databases from the inception to October 1， 2023. Meta-analysis was performed by RevMan 5.4 software after quality evaluation. Results Ten RCTs consisting of 930 patients were included in this meta-analysis. The meta-analysis results showed that compared with conventional nursing， multimodal prehabilitation could lower the incidence of postoperative complications （relative risk （RR） =0.62， 95%CI 0.47-0.82）， and shorten the length of hospital stay （mean difference （MD） =-6.15 d， 95%CI -7.87--4.43 d），reduce hospital costs （MD=CNY-17 800， 95%CI -27 600--8 100）， prolong 6-minute walking distance （MD=93.35 m， 95%CI 36.19-150.51 m） and increase serum albumin levels （MD=6.18 g/L， 95%CI 4.08-8.28 g/L） and IgG levels （standardized mean difference （SMD）=1.21， 95%CI 1.01-1.42）， respectively. Conclusions Multimodal prehabilitation can accelerate postoperative recovery， decrease the incidence of postoperative complications， improve partial exercise， nutritional and immunological indexes， shorten the length of hospital stay and reduce hospitalization costs.

Keywords

• esophageal neoplasm|multimodal prehabilitation|postoperative recovery|interventional effect|randomized controlled trial|meta-analysis