本次系统评价和荟萃分析的目的是更新关于运动干预预康复在减少癌症手术后并发症和住院时间方面的功效的证据。在 MEDLINE、Embase、 Cochrane 图书馆、CINAHL、AMED 和 PsycINFO 确定随机对照试验，调查预康复和运动干预对接受癌症手术的患者的影响。评估的主要和次要结局分别是术后并发症和住院时间。使用 Cochrane 偏倚风险工具评估偏倚风险，并使用建议分级、评估、制定和评价 (GRADE) 方法来确定证据的强度。使用随机效应荟萃分析计算相对风险和平均差异。在本次更新的综述中，确定了 32 项试验（n = 2304 名受试者），其中 5 项试验侧重于接受泌尿生殖癌手术的患者（n = 422 名受试者），9下消化道癌（n = 639 名参与者）、上消化道癌 6 名（n = 526 名）和肺癌 11 名（n = 717 名参与者）。大多数纳入的试验都存在一定的偏倚风险。低至中等质量的证据表明，术前锻炼的预康复可显着降低肺切除患者术后并发症发生率约 50%，并将住院时间缩短 2.5 天。对于其他癌症人群，术前运动并未显示出可有效减少术后并发症或缩短住院时间。有证据支持预康复运动可有效减少接受肺癌手术的患者的术后并发症和住院时间。需要进一步研究来确定单模式预康复与运动对接受癌症手术的泌尿生殖系统、下消化道和上消化道癌症人群的疗效。版权所有 © 2024 国际麻醉研究协会。

The objective of this systematic review and meta-analysis was to update the body of evidence on the efficacy of prehabilitation with exercise interventions, in reducing postoperative complications and length of hospital stay after cancer surgery.A comprehensive literature search was conducted on MEDLINE, Embase, The Cochrane Library, CINAHL, AMED, and PsycINFO to identify randomized controlled trials investigating the impact of prehabilitation with exercise interventions for patients undergoing cancer surgery. Primary and secondary outcomes assessed were postoperative complications and length of hospital stay, respectively. Risk of bias was evaluated using the Cochrane risk of bias tool, and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology was used to determine the strength of evidence. Relative risk and mean difference were calculated using random-effects meta-analysis.In this updated review, 32 trials (n = 2304 participants) were identified, with 5 trials focused on patients undergoing surgery for genitourinary cancer (n = 422 participants), 9 for lower gastrointestinal cancer (n = 639 participants), 6 for upper gastrointestinal cancer (n = 526), and 11 for lung cancer (n = 717 participants). The majority of included trials exhibited some risk of bias. Evidence of low-to-moderate quality indicated that prehabilitation with preoperative exercise significantly reduced postoperative complication rates by approximately 50% and decreased the length of hospital stay by 2.5 days in patients undergoing lung resection. Preoperative exercise did not demonstrate effectiveness in reducing postoperative complications or length of hospital stay for other cancer populations.Evidence supports the efficacy of prehabilitation with exercise in reducing postoperative complications and length of hospital stay in patients undergoing lung cancer surgery. Further research is warranted to establish the efficacy of unimodal prehabilitation with exercise in genitourinary, lower gastrointestinal, and upper gastrointestinal cancer populations having cancer surgery.Copyright © 2024 International Anesthesia Research Society.