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@ARTICLE{Heger:144055,
      author       = {P. Heger and P. Probst and J. Wiskemann and K.
                      Steindorf$^*$ and M. K. Diener and A. L. Mihaljevic},
      title        = {{A} {S}ystematic {R}eview and {M}eta-analysis of {P}hysical
                      {E}xercise {P}rehabilitation in {M}ajor {A}bdominal
                      {S}urgery ({PROSPERO} 2017 {CRD}42017080366).},
      journal      = {Journal of gastrointestinal surgery},
      volume       = {24},
      number       = {6},
      issn         = {1873-4626},
      address      = {New York, NY},
      publisher    = {Springer},
      reportid     = {DKFZ-2019-01606},
      pages        = {1375-1385},
      year         = {2020},
      note         = {2020 Jun;24(6):1375-1385},
      abstract     = {Physical exercise prehabilitation has been proposed to
                      improve postoperative outcomes in patients undergoing major
                      abdominal surgery. The aim of this systematic review was to
                      investigate the effect of preoperative exercise training
                      compared with standard care on postoperative outcomes in
                      major abdominal surgery.Randomized controlled trials (RCT)
                      comparing prehabilitation with standard care were identified
                      by a systematic literature search of MEDLINE and CENTRAL.
                      Qualitative and quantitative analyses of perioperative
                      outcome data were conducted. Meta-analyses were performed
                      wherever possible and meaningful.A total of eight trials
                      including 442 patients met the inclusion criteria. These
                      trials investigated the effect of prehabilitation in patient
                      cohorts undergoing major liver, colorectal,
                      gastroesophageal, and general abdominal surgery.
                      Quantitative analyses of all included trials showed a
                      significant reduction in postoperative pulmonary
                      complications (OR 0.37; 0.20 to 0.67; p = 0.001) as well
                      as in postoperative overall morbidity (OR 0.52; 0.30 to
                      0.88; p = 0.01) in the prehabilitation group compared
                      with standard care. The length of hospital stay showed no
                      significant differences between the groups (MD - 0.58;
                      - 1.28 to 0.13; p = 0.11). Risk of bias and
                      methodological quality varied substantially among the
                      trials, most of which were small single-center
                      studies.Prehabilitation including a physical exercise
                      intervention may lead to a reduction of postoperative
                      pulmonary complications as well as less overall morbidity
                      compared with standard care in patients undergoing major
                      abdominal surgery. Further, well-designed RCT are needed to
                      evaluate these potential positive effects in more detail and
                      to identify suitable target populations.PROSPERO 2017
                      CRD42017080366.},
      subtyp        = {Review Article},
      cin          = {C110},
      ddc          = {610},
      cid          = {I:(DE-He78)C110-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31228083},
      doi          = {10.1007/s11605-019-04287-w},
      url          = {https://inrepo02.dkfz.de/record/144055},
}