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Purpose <p>This study aims to assess the effectiveness of psychological prehabilitation in reducing postoperative complications and length of hospital stay in patients undergoing cancer surgery.</p> Methods <p>A comprehensive electronic search was conducted in CINAHL, Cochrane Library, Medline, PsycINFO, AMED and Embase databases from inception to December 2023. Randomised controlled trials assessing the effectiveness of psychological prehabilitation compared to control in patients undergoing abdominal, pelvic, and/or thoracic cancer surgery were included. The primary outcome measures were postoperative complications and length of hospital stay. Two independent reviewers extracted relevant information and assessed the risk of bias. Random-effect meta-analyses were used to pool outcomes, and the quality of evidence was assessed using GRADE.</p> Results <p>A total of 18 trials were identified (<i>N</i> = 1612) and 11 (<i>N</i> = 923) analysed, including eight multimodal (<i>N</i> = 719), one bimodal (<i>N</i> = 90) and two unimodal (<i>N</i> = 189). There was high-quality evidence that trials including psychological prehabilitation significantly reduced the incidence of overall postoperative complications in all cancer types included in the studies (relative risk: 0.73; 95% CI: 0.60 to 0.89) and abdominal cancer subgroup (relative risk: 0.65; 95% CI: 0.48 to 0.88) compared to control. Psychological prehabilitation was not effective in reducing length of hospital stay (mean difference: − 0.78; 95% CI: − 1.72 to 0.17).</p> Conclusion <p>Psychological prehabilitation appears effective in reducing postoperative complications in cancer patients. Future studies should investigate the optimal preoperative psychological interventions according to individual cancer groups undergoing surgery.</p>

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Prehabilitation including psychological interventions reduces overall postoperative complications following cancer surgery: a systematic review and meta-analysis of randomised controlled trials

  • 期刊论文

  • 发表日期：

    2025年11月17日

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  • Nicholas Hirst,
  • Michael J. Solomon,
  • Kate McBride,
  • Haryana Dhillon,
  • Zirong Bai,
  • Kate Alexander,
  • Se Won Jeon,
  • Daniel Steffens

摘要

Purpose

This study aims to assess the effectiveness of psychological prehabilitation in reducing postoperative complications and length of hospital stay in patients undergoing cancer surgery.

Methods

A comprehensive electronic search was conducted in CINAHL, Cochrane Library, Medline, PsycINFO, AMED and Embase databases from inception to December 2023. Randomised controlled trials assessing the effectiveness of psychological prehabilitation compared to control in patients undergoing abdominal, pelvic, and/or thoracic cancer surgery were included. The primary outcome measures were postoperative complications and length of hospital stay. Two independent reviewers extracted relevant information and assessed the risk of bias. Random-effect meta-analyses were used to pool outcomes, and the quality of evidence was assessed using GRADE.

Results

A total of 18 trials were identified (N = 1612) and 11 (N = 923) analysed, including eight multimodal (N = 719), one bimodal (N = 90) and two unimodal (N = 189). There was high-quality evidence that trials including psychological prehabilitation significantly reduced the incidence of overall postoperative complications in all cancer types included in the studies (relative risk: 0.73; 95% CI: 0.60 to 0.89) and abdominal cancer subgroup (relative risk: 0.65; 95% CI: 0.48 to 0.88) compared to control. Psychological prehabilitation was not effective in reducing length of hospital stay (mean difference: − 0.78; 95% CI: − 1.72 to 0.17).

Conclusion

Psychological prehabilitation appears effective in reducing postoperative complications in cancer patients. Future studies should investigate the optimal preoperative psychological interventions according to individual cancer groups undergoing surgery.