Preoperative rehabilitation for patients undergoing colorectal cancer surgery: a retrospective cohort study

Purpose We investigated the impact of preoperative short-term rehabilitation on activities of daily living among patients with colorectal cancer. Methods This retrospective cohort study utilized a hospital-based database containing Diagnosis Procedure Combination survey data from over 100 participating acute-care hospitals. We extracted data on consecutive inpatients hospitalized with stage 1 and 2 colorectal cancer. We compared characteristics and outcomes between patients who underwent short-term rehabilitation before surgery and those who did not. Primary outcomes measured were Barthel Index decline and number of complications during hospitalization. Results Among of included inpatients (male, 57%; older individuals aged over 65 years, 79%; mean Barthel Index, 93.4), the number of patients who underwent preoperative rehabilitation was 760 (39.3%). Patients in the preoperative rehabilitation group were less likely to have a decline in the Barthel Index compared with the control group (5.9% vs 10.1%, P < 0.001) and after propensity score adjustment using inverse probability weighting (6.3% vs 9.8%, P = 0.024). The preoperative rehabilitation group had fewer complications during hospitalization compared with the control group (P < 0.001) and after inverse probability weighting (P = 0.001). Conclusion Our study showed that preoperative short-term rehabilitation was associated with maintenance and improvement of activities of daily living and fewer complications among patients with stage 1 and 2 colorectal cancer.