Multimodal Prehabilitation Reduces Complications, Shortens Hospital Stays After Colorectal Surgery

Colorectal cancer surgery, while curative, is frequently associated with substantial postoperative morbidity, including infectious and non-infectious complications, and prolonged hospital stays [1, 2]. Efforts to mitigate these risks have increasingly focused on prehabilitation, a multidisciplinary approach that typically integrates exercise, nutritional support, and psychological counseling to enhance a patient's physiological reserve before surgery [3, 4]. While systematic reviews and meta-analyses have indicated that multimodal prehabilitation can improve functional capacity and reduce overall postoperative complications in selected patient cohorts [5, 3, 6], some studies have highlighted variability in outcomes, particularly regarding severe complications or sustained functional gains postoperatively [5, 7, 6, 8]. For instance, one meta-analysis found that multimodal prehabilitation significantly improved postoperative functional capacity by 32.95 meters (95% CI, 15.34-50.57) in the 6-minute walk test and reduced the risk of severe postoperative complications (risk ratio = 0.65, 95% CI, 0.46-0.93) [7]. The challenge remains in translating these findings into broad clinical practice, especially concerning the effectiveness of such programs in unselected, real-world patient populations across diverse healthcare settings.