PREHAB: multimodal prehabilitation before colorectal cancer surgery
PREHAB showed that four weeks of supervised training, protein and support before bowel cancer surgery cut severe complications and sped recovery, in an international randomised trial of 251 patients.
PREHAB was an international multicentre randomised trial (Netherlands, Denmark, Canada, Italy) registered in the Netherlands Trial Register (NTR5947). Patients in the prehabilitation arm had a lower rate of severe complications (Comprehensive Complication Index over 20) and about half the number of medical complications, with faster functional recovery and no delay in surgery attributable to the programme. The intervention was resource-intensive (three supervised sessions a week for four weeks) and adherence was high in a trial setting. It is the strongest single randomised result for prehabilitation, complementing meta-analyses that show consistent improvements in functional capacity but heterogeneous effects on complications, and it underpins national programmes such as NHS England's with Macmillan.
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