Journal Article

Effects of preoperative nutrition and multimodal prehabilitation on functional capacity and postoperative complications in surgical lung cancer patients: a systematic review

Carli, Francesco, Chevalier Stéphanie, Lawson, Claire, Ekmekjian Taline, Ferreira, Vanessa, Scheede-Bergdahl Celena

2021

Overview

ObjectiveTo determine the effect of preoperative nutrition and multimodal prehabilitation on clinical and functional outcomes in surgical lung cancer patients.MethodsWe searched MEDLINE, Cochrane Library and CENTRAL, EMBASE, Scopus, and clinical trial registries (clinicaltrials.gov, International Clinical Trials Registry Platform and Google Scholar) to identify studies involving a preoperative nutrition-based intervention or multimodal prehabilitation (nutrition with exercise) of at least 7 days, in lung cancer patients awaiting surgery. Studies must have reported results on at least one of the following outcomes: functional capacity, pulmonary function, postoperative complications, and length of hospital stay. The quality of included studies was assessed using the Cochrane risk of bias assessment tool for randomized trials and the modified Newcastle-Ottawa scale for non-controlled trials.ResultsFive studies were included (1 nutrition-only and 4 multimodal prehabilitation studies). Due to substantial heterogeneity in the interventions across studies, a meta-analysis was not conducted. Findings suggest that multimodal prehabilitation, compared with standard hospital care, is associated with improvements in both functional walking capacity and pulmonary function during the preoperative period; however it does not appear to have an effect on postoperative outcomes. Rather, the finding of significantly lower rates of postoperative complications in the intervention group was unique to the nutrition-only study.ConclusionMultimodal prehabilitation programs that combine nutrition and exercise may have beneficial effects on various physical function outcomes in patients with lung cancer awaiting surgery. Optimizing preoperative nutrition may have postoperative benefits which remain to be confirmed.

• Publisher: Springer Nature B.V
• Subject: Cancer / Cancer surgery / Clinical research / Clinical trials / Complications / Exercise / Function / Functional impairment / Functional status / Intervention / Length of stay / Lung cancer / Meta-analysis / Multimodality / Nutrition / Patients / Perioperative care / Physical ability / Postoperative morbidity / Postoperative period / Risk assessment / Surgery / Surgical outcomes / Systematic review / Thoracic surgery / Walking