Objective: To investigate the effect of a prehabilitation program on the postoperative hospital stay and complication burden in patients undergoing elective resection of a colorectal carcinoma.
Design: Comparative retrospective cohort study.
Method: The study population consisted of patients who had undergone elective resection of a colorectal carcinoma between 2017 and 2020 at the Elkerliek hospital in Helmond. Patients in the intervention group had surgery from May 1, 2019 and they followed a three to six-week prehabilitation program, focusing on physical condition, nutritional status and psychosocial well-being. Patients in the control group had surgery until May 1, 2019 and did not follow a prehabilitation program. The primary outcome measures were hospital stay and complication burden according to the Comprehensive Complication Index (CCI). The secondary outcome measures were the number and type of complications up to 90 days postoperatively.
Results: The intervention group (n=85) and control group (n=197) were almost comparable in preoperative patient and treatment characteristics. The intervention group had a shorter hospital stay (median 5 versus 6 days, p<0.001) and less often a heavy complication burden (18% versus 36%, p=0.002). The intervention group also contained fewer patients with a complication (25% versus 44%, p=0.002). Specifically, infection (4% vs 13%, p=0.018), pulmonary complication (2% vs 12%, p=0.009) and delirium (1% vs 9%, p=0.019) were less common.
Conclusion: A prehabilitation program can shorten the postoperative hospital stay and reduce the postoperative complication burden in patients undergoing elective resection for colorectal carcinoma.