Researchers looked at whether preparing for colorectal surgery with exercise, nutrition, and mental health support helps elderly patients recover better. They studied 547 patients aged 65-82 who either received this special preparation program combined with standard recovery care, or just standard recovery care alone. The good news: patients who did the preparation program could walk farther and longer after surgery. However, the study didn’t find big differences in hospital stay length, complications, or overall quality of life. While the results are promising, doctors say more research is needed to figure out exactly who benefits most from this approach.

The Quick Take

  • What they studied: Does preparing elderly patients with exercise, healthy eating, and mental support before colorectal cancer surgery help them recover better when combined with standard recovery programs?
  • Who participated: 547 elderly patients (ages 65-82) with colorectal cancer who were scheduled for surgery. Half received the special preparation program, and half received standard care only.
  • Key finding: Patients who did the preparation program walked about 18 meters farther in a 6-minute walking test after surgery compared to those who didn’t prepare. This suggests they had better physical fitness after their operation.
  • What it means for you: If you’re an elderly person facing colorectal surgery, preparing your body with exercise and nutrition before surgery may help you regain your walking ability faster. However, this doesn’t guarantee shorter hospital stays or fewer complications, so talk with your doctor about whether this approach is right for you.

The Research Details

Researchers searched through published medical studies to find all research comparing elderly patients who received multimodal prehabilitation (a combination of exercise, nutrition counseling, psychological support, and sometimes spiritual care) before surgery combined with standard recovery programs, versus patients who only received standard recovery programs. They selected six high-quality studies that met strict criteria for reliability. These studies included a total of 547 patients with colorectal cancer. The researchers then combined the results from these studies to look for patterns and overall effects.

The researchers measured several important outcomes: how long patients stayed in the hospital, how far patients could walk in six minutes (a test of physical fitness), whether patients had complications after surgery, and how satisfied patients were with their quality of life. They used statistical methods to combine results fairly and check whether the studies were similar enough to compare.

All the patients studied had colorectal cancer and were scheduled for planned (elective) surgery. The patients in the preparation group were between 65-78 years old on average, while the control group averaged 66-82 years old. This careful selection of studies and patients helps ensure the findings are reliable.

This research approach matters because it combines evidence from multiple high-quality studies, which gives us a clearer picture than any single study could provide. By looking at studies with low risk of bias (meaning the results weren’t skewed by poor research methods), the researchers could confidently say what the evidence actually shows. Understanding whether preparing the body before surgery helps elderly patients is important because it could change how doctors prepare patients and potentially improve their recovery.

This meta-analysis included only six studies, which is a relatively small number, so the findings should be considered preliminary. However, all six studies were rated as having low risk of bias and good quality, meaning the research methods were sound. The studies were fairly consistent with each other (low heterogeneity), which strengthens the findings. The main limitation is that all patients studied had colorectal cancer, so results may not apply to other types of surgery. Additionally, the walking test improvement was modest (about 18 meters), and researchers didn’t find improvements in other important measures like hospital stay length or complications.

What the Results Show

The most clear finding was that elderly patients who received the preparation program walked significantly farther in a six-minute walking test after surgery—about 18 meters farther than those who didn’t prepare. This is a real difference, though it’s relatively modest. This suggests that the preparation program helped patients maintain or improve their physical fitness and strength, which is important for recovery.

However, when researchers looked at other important outcomes, they didn’t find significant differences. The length of hospital stay was similar between the two groups, meaning patients who prepared didn’t necessarily go home sooner. The rate of complications after surgery (like infections or other problems) was also similar between groups. Additionally, patients’ overall satisfaction with their quality of life after surgery didn’t differ significantly between those who prepared and those who didn’t.

When researchers looked at different types of studies separately or compared different control groups, the results remained consistent. This means the findings weren’t driven by one particular study or type of comparison. The consistency of results across different analyses suggests the findings are fairly reliable, even though the overall effects are modest.

The research didn’t identify major differences in other recovery measures between the two groups. This includes infection rates, wound healing problems, and other surgical complications. The fact that preparation didn’t reduce complications is somewhat surprising and suggests that while exercise and nutrition may help with physical fitness, they may not prevent the medical complications that can occur after surgery. Quality of life measures, which assess how patients feel and function in daily life after surgery, also showed no significant differences between groups.

This research builds on previous studies showing that both enhanced recovery programs (ERAS) and preparation programs (prehabilitation) individually can help surgical patients. This meta-analysis is one of the first to systematically examine what happens when you combine both approaches. The finding that combined programs improve walking ability but not hospital stay or complications suggests that while preparation helps maintain fitness, it may not dramatically change the overall recovery timeline or prevent complications. This fits with the emerging understanding that different interventions help different aspects of recovery.

The study only included patients with colorectal cancer, so results may not apply to other types of surgery. Only six studies were included, which is a small number for a meta-analysis. The improvement in walking distance (18 meters) is real but modest—it’s unclear whether this translates to meaningful improvements in daily life. The studies didn’t measure some important outcomes like pain levels, return to normal activities, or long-term health. Additionally, the studies varied in exactly what preparation activities they included, which could affect results. The research didn’t identify which specific components of the preparation program (exercise, nutrition, psychology, or spirituality) were most helpful.

The Bottom Line

Based on moderate evidence, elderly patients scheduled for colorectal surgery may benefit from a preparation program combining exercise, nutrition counseling, and psychological support before surgery. This appears to help maintain physical fitness after surgery. However, the evidence is not strong enough to say this will definitely shorten hospital stays or prevent complications. Patients should discuss with their surgical team whether such a program is appropriate for their specific situation. The recommendation is to consider prehabilitation as part of a comprehensive approach to surgery preparation, not as a replacement for standard care.

Elderly patients (65 and older) scheduled for colorectal cancer surgery should discuss this approach with their surgical team. People who are physically active or motivated to prepare for surgery may benefit most. This may be less relevant for patients with severe health conditions that limit exercise, though even they should consult their doctors. Family members and caregivers should know that while preparation may help with fitness, it’s not a guarantee of faster recovery or fewer complications. Healthcare providers managing elderly surgical patients should consider offering comprehensive preparation programs as part of standard care.

If you start a preparation program, you might expect to see improvements in physical fitness within 2-4 weeks of consistent exercise and nutrition changes. After surgery, the benefits of preparation may be most noticeable in the first few weeks of recovery, particularly in your ability to walk and move around. However, don’t expect dramatically shorter hospital stays—most benefits appear to be in maintaining strength and fitness rather than changing the overall recovery timeline. Long-term benefits may include better quality of life and faster return to normal activities, though this wasn’t clearly demonstrated in these studies.

Want to Apply This Research?

  • Track daily steps walked and distance covered before and after surgery using a step counter or fitness app. Record weekly exercise sessions (type, duration, and how you felt). Monitor nutrition by logging meals and water intake. This creates a baseline before surgery and shows progress during recovery.
  • If facing colorectal surgery, use the app to: (1) Set up a pre-surgery exercise plan with your doctor (aim for 150 minutes of moderate activity weekly if cleared), (2) Log daily nutrition focusing on protein intake and hydration, (3) Schedule and track mental health check-ins or relaxation exercises, (4) Set post-surgery walking goals starting with short distances and gradually increasing.
  • Create a 12-week tracking plan: 4-6 weeks before surgery (establish baseline fitness and nutrition habits), 2 weeks immediately before (maintain routine), and 6 weeks after surgery (gradually rebuild activity). Use the app to compare pre-surgery and post-surgery walking distances and fitness levels. Share data with your healthcare team to adjust your recovery plan as needed.

This research summary is for educational purposes only and should not replace professional medical advice. The findings apply specifically to elderly patients undergoing colorectal cancer surgery and may not apply to other types of surgery or patient populations. Before starting any exercise program or preparation for surgery, consult with your doctor or surgical team. Individual results vary, and what works for one person may not work for another. If you have existing health conditions, mobility limitations, or concerns about surgery preparation, discuss them with your healthcare provider before making any changes to your routine.