Frontiers in oncology · 2026
Impact of a multimodal prehabilitation program on postoperative recovery in patients undergoing total laparoscopic hysterectomy and its clinical effects on reducing the risk of venous thromboembolism occurrence.
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Qu Liuhua, Yang Ling, Li Lu
Аннотация
BACKGROUND: Postoperative recovery and venous thromboembolism (VTE) are major concerns following total laparoscopic hysterectomy (TLH). This study aimed to evaluate the impact of a multimodal prehabilitation program on postoperative recovery and its clinical effects on reducing VTE risk in patients undergoing TLH.
METHODS: This retrospective study involved 274 patients who underwent TLH for benign uterine diseases. Patients were divided into a conventional group (n = 145) and a prehabilitation group (n = 129). Postoperative recovery indicators, Caprini risk scores, lower extremity deep vein thrombosis (DVT) incidence, serum markers (coagulation function and inflammatory parameters), and complications were compared between groups.
RESULTS: Compared with the conventional group, patients in the prehabilitation group demonstrated significantly shorter times to first anal exhaust (22.63 ± 4.38 vs. 24.47 ± 5.44 h, P = 0.002), first bowel movement (61.08 ± 6.23 vs. 63.26 ± 7.21 h, P = 0.008), first ambulation (18.45 ± 3.74 vs. 22.34 ± 4.09 h, P < 0.001), and postoperative hospital stay (4.39 ± 0.71 vs. 6.95 ± 1.03 days, P < 0.001). Postoperative pain scores at 6, 24, and 48 h were also significantly lower in the prehabilitation group (all P < 0.05). Additionally, the prehabilitation group showed improved postoperative Caprini risk profiles (P < 0.001) and significantly lower incidence of lower-extremity DVT (2.33% vs. 14.48%, P < 0.001). Coagulation function and inflammatory markers were also significantly improved in the prehabilitation group. Multivariate analysis further identified the prehabilitation program as an independent protective factor against postoperative DVT (OR = 0.223, 95%CI: 0.099-0.502, P < 0.001).
CONCLUSION: Multimodal prehabilitation significantly enhances postoperative recovery and reduces the risk of venous thromboembolism in patients undergoing TLH.
METHODS: This retrospective study involved 274 patients who underwent TLH for benign uterine diseases. Patients were divided into a conventional group (n = 145) and a prehabilitation group (n = 129). Postoperative recovery indicators, Caprini risk scores, lower extremity deep vein thrombosis (DVT) incidence, serum markers (coagulation function and inflammatory parameters), and complications were compared between groups.
RESULTS: Compared with the conventional group, patients in the prehabilitation group demonstrated significantly shorter times to first anal exhaust (22.63 ± 4.38 vs. 24.47 ± 5.44 h, P = 0.002), first bowel movement (61.08 ± 6.23 vs. 63.26 ± 7.21 h, P = 0.008), first ambulation (18.45 ± 3.74 vs. 22.34 ± 4.09 h, P < 0.001), and postoperative hospital stay (4.39 ± 0.71 vs. 6.95 ± 1.03 days, P < 0.001). Postoperative pain scores at 6, 24, and 48 h were also significantly lower in the prehabilitation group (all P < 0.05). Additionally, the prehabilitation group showed improved postoperative Caprini risk profiles (P < 0.001) and significantly lower incidence of lower-extremity DVT (2.33% vs. 14.48%, P < 0.001). Coagulation function and inflammatory markers were also significantly improved in the prehabilitation group. Multivariate analysis further identified the prehabilitation program as an independent protective factor against postoperative DVT (OR = 0.223, 95%CI: 0.099-0.502, P < 0.001).
CONCLUSION: Multimodal prehabilitation significantly enhances postoperative recovery and reduces the risk of venous thromboembolism in patients undergoing TLH.