Prehabilitation in lung cancer surgery: A review and meta-analysis of RCT studies

Prehabilitation to maximize exercise capacity before lung cancer surgery has the potential to improve operative tolerability and patient outcomes. Although prehabilitation becomes popular in cancer surgery, it is not common in thoracic surgery in clinical practice. MATERIAL & METHOD: We conducted a systematic literature search through PubMed/Medline covering completed trials from 2010 to 2021 and included randomised controlled trials (RCTs) in which they studied participants who were scheduled to undergo lung resection for NSCLC and were allocated to receive either prehabilitation or no. The data was collected and analyzed by 2 review authors independently who screened the studies and selected those for inclusion. We analyzed the duration of prehabilition and the benefits for the patients perioperatively in comparison to those who did not receive exercise training preoperatively. Results: Preoperative exercise training may reduce the risk of developing a postoperative pulmonary complication, postoperative need for pain analgesia and length of hospital stay. It also might improve both exercise capacity and FVC in people undergoing lung resection for NSCLC. Conclusion: Although our findings should be interpreted very carefully due to the differences of the RCT’s studies we included, one should admit that prehabilitation should be included as rule in lung cancer surgery. At a time when healthcare is under pressure to provide patient-centered value-based care, prehabilitation provides a potentially cost-effective opportunity to to reduce complications after surgery and significantly reduce healthcare expenditure.