Prehabilitation and postoperative outcomes in gastric cancer surgery: a systematic review and meta-analysis
Year: 2026
Type: article
Study designs: Systematic Review, Meta-Analysis
Abstract: Background: 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.Methods: 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.Results: 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%).Conclusions: 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.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7224082313