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Pre-habilitation before colorectal cancer surgery could improve postoperative gastrointestinal function recovery: a case-matched study

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Abstract

Purpose

While its effect is controverted, multimodal pre-habilitation could be used to improve the postoperative course following colorectal cancer surgery. However, by increasing lean body mass, pre-habilitation could reduce the time needed to recover gastrointestinal (GI) functions. The aim was to assess the impact of pre-habilitation before colorectal cancer surgery on postoperative GI motility recovery.

Methods

This is a matched retrospective study based on a prospective database including patients undergoing colorectal surgery without pre-habilitation (NPH) (2016–2018) and with pre-habilitation (PH group) (2018–2019). The main outcome measure was the time to GI-3 recovery (tolerance to solid food and flatus and/or stools).

Results

One hundred thirteen patients were included, 37 underwent pre-habilitation (32.7%). The patient’s age, the surgical procedure, the surgical access, the rate of synchronous metastasis, the rate of preoperative chemoradiotherapy, and the rate of stoma were more important in the PH group. Conversely, the rate of patients with an ASA score of > 2 was higher in the NPH group. By matching patients according to age, gender and surgical procedure, 84 patients were compared (61 in the NPH group and 23 in the PH group). The mean of GI-3 recovery was significantly lower in the PH group. The other endpoints were not significantly different but time to GI function recovery and medical morbidity tended to be higher in the NPH group. Compliance with the enhanced recovery program was significantly higher in the PH group.

Conclusion

Pre-habilitation before colorectal cancer surgery reduced time to GI function recovery and may increase compliance with the enhanced recovery program.

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Author information

Authors and Affiliations

  1. Department of Visceral Surgery, CHU Angers, 4 rue Larrey, 49933 ANGERS Cedex 9, Angers, France

    F. Fabulas, S. Mucci, C. Casa, P. Le Naoures & Aurélien Venara

  2. Department of Medicine, Faculty of Health of Angers, Angers, France

    F. Fabulas, M. Dinomais, J. F. Hamel, J. Perrot & Aurélien Venara

  3. CRRRF, Angers, France

    P. Paisant & M. Dinomais

  4. Department of Biostatistics, CHU Angers, La Maison de la Recherche4 rue Larrey, 49933 ANGERS Cedex 9, Angers, France

    J. F. Hamel & J. Perrot

  5. HIFIH, UPRES, Angers, France

    Aurélien Venara

Authors
  1. F. Fabulas
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  2. P. Paisant
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  3. M. Dinomais
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  4. S. Mucci
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  5. C. Casa
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  6. P. Le Naoures
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  7. J. F. Hamel
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  8. J. Perrot
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  9. Aurélien Venara
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Contributions

All the authors contributed to the study conception and design. Material preparation: Fabulas, Paisant, Dinomais, Venara. Data collection: Fabulas, Paisant, Casa, Mucci, Le Naoures, Data analysis: Fabulas, Perrot, Hamel, Venara. Writing — original draft preparation: Fabulas, Paisant, Perrot, Venara. Writing — review and editing: Fabulas, Paisant, Dinomais, Casa, Mucci, Le Naoures, Hamel, Perrot, Venara. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Aurélien Venara.

Ethics declarations

Ethics approval

Ethical approval was waived by the local Ethics Committee of the University of A in view of the retrospective nature of the study and the fact that all the procedures being performed were part of routine care.

Consent to participate

Being a retrospective study, all patients were informed that their data could be used for medical research and were asked to indicate if they did not agree to such use. None of the patients indicated disagreement.

Conflict of interest

The authors declare no competing interests.

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Fabulas, F., Paisant, P., Dinomais, M. et al. Pre-habilitation before colorectal cancer surgery could improve postoperative gastrointestinal function recovery: a case-matched study. Langenbecks Arch Surg 407, 1595–1603 (2022). https://doi.org/10.1007/s00423-022-02487-8

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  • DOI: https://doi.org/10.1007/s00423-022-02487-8

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