SP3.9 - Evaluating the effects of prehabilitation on patients undergoing resections for colorectal cancer

Abstract Background Surgery is the mainstay of treatment for colorectal cancer (CRC), often associated with delayed recovery. Prehabilitation is a trimodal service aimed at optimising the physical, nutritional, and psychological wellbeing of patients prior to surgery. This study aims to compare the effect of prehabilitation on patient outcomes. Methods This is a retrospective study including all patients undergoing elective surgical resections for CRC at a tertiary centre between January-July 2022, categorised in two groups: standard pre-op care (non-prehab) vs those getting prehabilitation (prehab). Primary outcomes were length of stay (LOS) and post-operative complications (Clavien Dindo classification). Secondary goals were to identify proportion of patients received screening for nutrition and diabetic control. p<0.05 was considered statistically significant. Results Ninety-five patients were included (54 males, 41 females). 76% (n=71) were referred for prehabilitation. Median time to the first prehabilitation appointment was 7 days (IQR 0-61). LOS was reduced by one day (prehab 8 days, non-prehab 9 days, p=0.186). This equated to cost saving of £41,606 in the prehab group (£586.00 per day). Patients in the prehab group developed fewer post-operative complications (46%, n=33) compared to the non-prehab group (67%, n=16), p=0.042) Based on Clavien-Dindo classification, non-prehab group developed more severe post-operative complications compared to prehab (CD 4-5, 4% vs 0% respectively). Only 41% patients of the whole cohort (n=39) had nutritional bloods taken and 57% (n=54) were screened for diabetes. Conclusion Prehabilitation is useful in reducing post-operative complications rates and inpatient expenses. Future studies may improve on optimising nutrition and diabetic control.