Prospective Evaluation of Multimodal Prehabilitation in Esophagogastric Cancer Surgery: Enhancing Patient Outcomes.

Abstract

The significance of prehabilitation in contemporary esophagogastric surgical procedures is yet to be fully understood, due to heterogeneity in the available research. This research was conducted to assess the impact of a structured home-based multimodal prehabilitation approach on the postsurgical outcomes of patients undergoing surgery for esophagogastric cancer. This study was a prospective, nonrandomized investigation carried out on individuals scheduled for curative esophagogastric cancer surgery. Participants underwent a home-based, multimodal prehabilitation regimen that incorporated structured physical exercises, nutritional support, psychological counseling, and assistance in quitting smoking and alcohol use. The primary outcome measured was the incidence of postoperative pneumonia, defined according to the revised Uniform Pneumonia Scoring system from day 1 to day 4 post-surgery. A total of 94 patients were analyzed. A total of 50 patients underwent multimodal prehabilitation for a minimum of 2 weeks with a compliance rate of more than 60% and were included in the intervention group, whereas the rest 44 with compliance less than 60% or unwilling to undergo prehabilitation were included in the control group. A statistically significant difference was seen in the incidence of postoperative pneumonia between the two groups. Structured multimodal prehabilitation done for 2 weeks before surgery improves outcomes in patients undergoing esophagogastric cancer surgery.