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Comparative study using propensity score matching analysis in patients undergoing surgery for colorectal cancer with or without multimodal prehabilitation

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Introduction

The complication rate after major abdominal surgery is from 35 to 50%. The multimodal prehabilitation covers all the pre-operative problems to guarantee a faster recovery and reduce the rate of morbidity and mortality after a colorectal procedure.

Methods

Observational study, in patients with CRC who underwent surgical treatment between November 2020 and September 2022. The data of the patients were placed in 2 groups: prehabilitation group (PPH) and no prehabilitation group (NPPH). Demographic data, type of cancer, operative data, and postoperative data were collected. Characteristics between the groups were compared after a propensity score matching (PSM) analysis for the detection of differences.

Results

After the PSM analysis, 46 patients were in PPH, and 63 patients were in NPPH. There was no significant difference in postoperative complications (p = 0.192). The median of comprehensive complication index (CCI) was 0 (p = 0.552). Patients in the NPPH had more hospital readmissions (p = 0.273) and more emergency room visits (p = 0.092). Multivariate log binomial regression adjusted for complications showed that pre-habilitation reduces the risk of a pos-operative complication (OR: 0.659, 95%CI, 0.434–1.00, p = 0.019).

Conclusions

The postoperative complication rate and LOS were similar between patients who receive operative multimodal prehabilitation for CRC surgery and those who did not. Prehabilitation was associated with reduced risk of postoperative complication after multivariate log binomial regression adjusted for complications. Patients who underwent prehabilitation had a slightly lower tendency for postoperative ER visits and hospital readmissions.

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Data availability

The datasets used during the current study is available from the corresponding author on reasonable request.

Material availability

No material from other sources was included in the article.

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Funding

This review received no specific grant from any funding agency, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Felicio Rocho Hospital, Av. do Contorno 9530-Barro Preto, Rua Tenente Brito Melo 496, Belo Horizonte, MG, CEP 30180070, Brazil

    Daniel Mauricio Londoño Estrada, Fábio Lopes de Queiroz, Luiza Iannotta Guerra, Paulo Rocha França-Neto & Antônio Lacerda-Filho

  2. Department of Nutrition, Felicio Rocho Hospital, Av. do Contorno, 9530-Barro Preto, Belo Horizonte, Brazil

    Simone Chaves de Miranda Silvestre

  3. Department of Anesthesiology, Felicio Rocho Hospital, Av. do Contorno, 9530-Barro Preto, Belo Horizonte, Brazil

    Jose Marcos Coelho

  4. Department of Surgery, Federal University of Minas Gerais School of Medicine, Av. Prof. Alfredo Balena, 190-Santa Efigênia, Belo Horizonte, Brazil

    Antônio Lacerda-Filho

Authors
  1. Daniel Mauricio Londoño Estrada
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  2. Fábio Lopes de Queiroz
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  3. Luiza Iannotta Guerra
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  4. Paulo Rocha França-Neto
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  6. Simone Chaves de Miranda Silvestre
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  7. Jose Marcos Coelho
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Contributions

Conception and design: DL and LG. Conducted research: FL. Data analysis and interpretation: DL, FL, PR, AL, SS, and JC. Manuscript writing and final approval of manuscript: all authors.

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Correspondence to Daniel Mauricio Londoño Estrada.

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Estrada, D.M.L., de Queiroz, F.L., Guerra, L.I. et al. Comparative study using propensity score matching analysis in patients undergoing surgery for colorectal cancer with or without multimodal prehabilitation. Int J Colorectal Dis 38, 256 (2023). https://doi.org/10.1007/s00384-023-04547-x

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