Journal of thoracic disease · 2026
Effects of prehabilitation on outcomes among patients undergoing surgery for lung cancer: a systematic review and meta-analysis of randomized controlled trials.
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Li Dan, Lv Yan, Wang Rui, Li Jiaqi, Zhang Yanqiang, Rong Yanni, Li Xiaona, Gao Le
Аннотация
BACKGROUND: Postoperative complications are common after lung cancer surgery and can significantly impair patients' recovery. Prehabilitation aims to optimize patients' physiological and functional status through multimodal interventions. This study systematically evaluated the effects of prehabilitation on perioperative outcomes among patients undergoing lung cancer surgery.
METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched PubMed, Embase, and other relevant databases from inception to January 2026. Randomized controlled trials (RCTs) comparing prehabilitation (including exercise-based components) with usual care were eligible for inclusion. The primary outcomes were preoperative changes in six-minute walk distance (Δ6MWD, defined as post-prehabilitation minus baseline values) and postoperative length of hospital stay (LOS). Secondary outcomes included postoperative pulmonary complications (PPCs) and preoperative changes in health-related quality of life (ΔHRQoL, defined as post-prehabilitation minus baseline values). A random-effects meta-analysis was performed, along with predefined subgroup analyses.
RESULTS: Fifteen RCTs involving 1,129 patients were included. The pooled analysis showed that prehabilitation significantly improved preoperative functional exercise capacity, with a mean increase in preoperative Δ6MWD of 37.58 m. Greater improvements were observed with interventions lasting >2 weeks. Prehabilitation also significantly reduce postoperative LOS. Additionally, it significantly reduced the risk of PPCs (odds ratio =0.39) and significantly improved preoperative ΔHRQoL.
CONCLUSIONS: Prehabilitation effectively enhances functional capacity, reduces LOS, PPCs, and improves quality of life in patients undergoing lung cancer surgery, supporting its role as a valuable perioperative management strategy.
METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched PubMed, Embase, and other relevant databases from inception to January 2026. Randomized controlled trials (RCTs) comparing prehabilitation (including exercise-based components) with usual care were eligible for inclusion. The primary outcomes were preoperative changes in six-minute walk distance (Δ6MWD, defined as post-prehabilitation minus baseline values) and postoperative length of hospital stay (LOS). Secondary outcomes included postoperative pulmonary complications (PPCs) and preoperative changes in health-related quality of life (ΔHRQoL, defined as post-prehabilitation minus baseline values). A random-effects meta-analysis was performed, along with predefined subgroup analyses.
RESULTS: Fifteen RCTs involving 1,129 patients were included. The pooled analysis showed that prehabilitation significantly improved preoperative functional exercise capacity, with a mean increase in preoperative Δ6MWD of 37.58 m. Greater improvements were observed with interventions lasting >2 weeks. Prehabilitation also significantly reduce postoperative LOS. Additionally, it significantly reduced the risk of PPCs (odds ratio =0.39) and significantly improved preoperative ΔHRQoL.
CONCLUSIONS: Prehabilitation effectively enhances functional capacity, reduces LOS, PPCs, and improves quality of life in patients undergoing lung cancer surgery, supporting its role as a valuable perioperative management strategy.