Nutritional prehabilitation strategies for patients undergoing colorectal cancer operations: a scoping review

Purpose The aim of this review was to describe the nutritional intervention strategies involved in prehabilitation studies for colorectal cancer patients, including screening or evaluation, intervention, implementation, and outcomes. Methods The scoping review used the framework established by Joanna Briggs Institute. Results We summarized the individualized nutritional prehabilitation strategies stratified by nutrition status for > 7 days before colorectal cancer surgery and identified the nutritional prehabilitation impacts on the physical and nutritional status of colorectal cancer patients. This scoping review used the Joanna Briggs Institute framework and included 32 of the 808 identified studies. Only 30 studies reported nutritional assessment, but there was significant heterogeneity in nutritional assessment tools. The most common assessment tool for nutritional status was the Subjective Global Assessment (SGA); 34% (n = 11) used tools by dietitians. The Subjective Global Assessment (n = 11) was the most commonly used nutritional assessment method. Of the 32 included articles, 11 reported risk stratification by nutritional status before the intervention. Twenty-three (72%) studies provided nutritional prehabilitation goals; only six (19%) used recognized nutritional guidelines. The most common preoperative nutrition strategy was the addition of protein-based products. Protein requirements were estimated at 1.2-1.8 g/kg/day (n = 15), twice/day (n = 11), or once/day (n = 7). Ten studies monitored compliance with nutritional interventions via telephone interviews; however, only one reported nutritional intervention adjustments after telephone follow-up. Moreover, approximately 50% of the studies (n = 15) did not assess nutritional outcomes. Conclusions We summarized the prehabilitation strategies stratified by nutrition risk based on nutrition status before colorectal cancer surgery to provide a potential reference for the development of personalized nutrition intervention strategies in the future.