Comparative Efficacy of Different Prehabilitation Strategies in Colorectal Surgery Patients: A Network Meta-Analysis.

The nutritional intervention was based on only 1 study with 43 participants, so its results are unstable. The network had no closed loops, so direct and indirect evidence could not be formally checked for consistency. Many comparisons had wide confidence intervals, especially for readmission, so apparent trends may not reflect real differences. Intervention details such as duration, intensity and adherence were not sufficiently reported to judge dose-response. Follow-up was short, so long-term functional recovery and quality of life were not assessed. The analysis included all colorectal surgery patients but focused on cancer, so results may not apply to inflammatory bowel disease or other surgical groups. Risk of bias was generally low, but some studies had uncertain randomization or deviations from intended interventions.

The investigators reported no financial or nonfinancial disclosures.

Do not conclude that multimodal prehabilitation is proven better than exercise alone for every outcome. Exercise showed a reported walking-distance gain of 62.85 m versus standard care, while multimodal prehabilitation showed a reported gain of 29.36 m versus standard care. Multimodal prehabilitation showed a clear complication reduction. Neither strategy showed a clear reduction in hospital stay or readmission.