Prehabilitation and postoperative outcomes in gastric cancer surgery: a systematic review and meta-analysis.
4 affiliations
- 1Department of Surgery, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea.
- 2Division of Gastrointestinal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
- 3Department of Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
- 4Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Abstract
Multimodal prehabilitation is a promising strategy for enhancing postoperative recovery and resilience to surgical stress; however, its benefit in gastric cancer surgery remains uncertain. We aimed to evaluate the impact of prehabilitation on postoperative recovery in patients undergoing radical gastrectomy. A systematic search of PubMed, Embase, and the Cochrane Library was conducted from inception to July 2025. Randomized controlled trials (RCTs) and non-randomized studies (NRS) comparing any form of prehabilitation with conventional preoperative care in patients undergoing radical gastrectomy were included. Data extraction followed PRISMA guidelines, and pooled analyses were performed using Stata 19.5 SE. Random-effects models generated risk ratios (RRs) or weighted mean differences (WMDs), and heterogeneity was assessed using the I² statistic. The primary outcome was postoperative pulmonary complications; secondary outcomes included overall complications and recovery indicators. Ten RCTs and five NRS met the inclusion criteria. Prehabilitation significantly reduced pulmonary complications in both RCTs [RR, 0.50; 95% confidence interval (CI), 0.33-0.75; I2=0%] and NRS (RR, 0.49; 95% CI, 0.35-0.69; I2=0%). A non-significant reduction in overall complications was observed in RCTs (RR, 0.64; 95% CI, 0.37-1.10; I2=74.4%) and NRS (RR, 0.83; 95% CI, 0.50-1.40; I2=30.9%). Prehabilitation was associated with a significant reduction in length of hospital stay in both RCTs (WMD, -0.86 days; 95% CI, -1.44 to -0.27; I2=0%) and NRS (WMD, -2.72 days; 95% CI, -3.10 to -2.33; I2=82.1%). Prehabilitation may reduce postoperative pulmonary complications and shorten hospital stay in patients undergoing gastrectomy, supporting its integration into enhanced recovery pathways. Standardized, large-scale RCTs are needed to validate its long-term clinical impact and oncologic safety.
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BibTeX
@article{lee2026prehabilitation,
title = {{Prehabilitation and postoperative outcomes in gastric cancer surgery: a systematic review and meta-analysis.}},
author = {Soo-Young Lee and Seong-A Jeong and Hyun-Jung Kim and Ji-Hoon Kim},
journal = {Journal of gastrointestinal oncology},
year = {2026},
month = aug,
doi = {10.21037/jgo-2026-0739},
url = {https://europepmc.org/article/MED/42996884},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Prehabilitation and postoperative outcomes in gastric cancer surgery: a systematic review and meta-analysis.
AU - Soo-Young Lee
AU - Seong-A Jeong
AU - Hyun-Jung Kim
AU - Ji-Hoon Kim
PY - 2026
DA - 2026/08/17
JO - Journal of gastrointestinal oncology
DO - 10.21037/jgo-2026-0739
UR - https://europepmc.org/article/MED/42996884
AB - Multimodal prehabilitation is a promising strategy for enhancing postoperative recovery and resilience to surgical stress; however, its benefit in gastric cancer surgery remains uncertain. We aimed to evaluate the impact of prehabilitation on postoperative recovery in patients undergoing radical gastrectomy. A systematic search of PubMed, Embase, and the Cochrane Library was conducted from inception to July 2025. Randomized controlled trials (RCTs) and non-randomized studies (NRS) comparing any form of prehabilitation with conventional preoperative care in patients undergoing radical gastrectomy were included. Data extraction followed PRISMA guidelines, and pooled analyses were performed using Stata 19.5 SE. Random-effects models generated risk ratios (RRs) or weighted mean differences (WMDs), and heterogeneity was assessed using the I² statistic. The primary outcome was postoperative pulmonary complications; secondary outcomes included overall complications and recovery indicators. Ten RCTs and five NRS met the inclusion criteria. Prehabilitation significantly reduced pulmonary complications in both RCTs [RR, 0.50; 95% confidence interval (CI), 0.33-0.75; I2=0%] and NRS (RR, 0.49; 95% CI, 0.35-0.69; I2=0%). A non-significant reduction in overall complications was observed in RCTs (RR, 0.64; 95% CI, 0.37-1.10; I2=74.4%) and NRS (RR, 0.83; 95% CI, 0.50-1.40; I2=30.9%). Prehabilitation was associated with a significant reduction in length of hospital stay in both RCTs (WMD, -0.86 days; 95% CI, -1.44 to -0.27; I2=0%) and NRS (WMD, -2.72 days; 95% CI, -3.10 to -2.33; I2=82.1%). Prehabilitation may reduce postoperative pulmonary complications and shorten hospital stay in patients undergoing gastrectomy, supporting its integration into enhanced recovery pathways. Standardized, large-scale RCTs are needed to validate its long-term clinical impact and oncologic safety.
SN - 2078-6891
SN - 2219-679X
ER -