{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T22:53:53Z","timestamp":1787093633605,"version":"build-2736575974"},"reference-count":42,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Faculty of Nursing and Midwifery of the Wroclaw Medical University in Poland","award":["SUBZ.L010.26.045"],"award-info":[{"award-number":["SUBZ.L010.26.045"]}]},{"award":["SUBZ.L010.26.045"],"award-info":[{"award-number":["SUBZ.L010.26.045"]}],"id":[{"id":"https:\/\/ror.org\/01qpw1b93","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Faculty of Medicine of the Wroclaw University of Science and Technology in Poland"},{"id":[{"id":"https:\/\/ror.org\/008fyn775","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Colorectal cancer (CRC) remains one of the most common malignancies worldwide. Despite advances in surgical techniques and the implementation of Enhanced Recovery After Surgery (ERAS) protocols, a substantial proportion of patients continue to experience postoperative complications and persistent functional impairment. Multimodal prehabilitation, combining physical exercise, nutritional optimization, and behavioral support, has been proposed as a strategy to enhance functional reserve prior to surgical treatment. The aim of this review was to provide a critical narrative evaluation of current clinical evidence regarding the effectiveness and safety of prehabilitation in patients with CRC. Methods: A targeted literature review was conducted in PubMed, Embase, CINAHL, Scopus, and Web of Science (2015\u20132025), identifying 23 primary studies, including 18 randomized and 5 non-randomized trials. Results: Most multimodal prehabilitation programs resulted in significant improvements in functional capacity prior to CRC resection. Functional outcomes were most commonly assessed using the six-minute walk test, cardiopulmonary fitness parameters, and measures of muscle strength, with good tolerance and high patient adherence. Several studies also demonstrated reductions in postoperative complication rates, shorter hospital stays, and faster recovery of independence, particularly among older patients, those with frailty, or reduced baseline functional capacity, although these effects were not fully consistent across studies. Conclusions: Available clinical evidence supports multimodal prehabilitation as a safe and feasible strategy that consistently preserves and enhances functional reserve prior to CRC surgery. However, its capacity to modify hard perioperative outcomes (such as complication rates and length of stay) remains inconsistent across current RCTs, showing clear efficacy predominantly in targeted high-risk, frail, or malnourished cohorts.<\/jats:p>","DOI":"10.3390\/jcm15114128","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:31:56Z","timestamp":1779885116000},"page":"4128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Effectiveness and Safety of Multimodal Prehabilitation in Colorectal Cancer Surgery\u2014A Narrative State-of-the-Art Review of Research and Clinical Trials"],"prefix":"10.3390","volume":"15","author":[{"given":"Dorota","family":"Zierkiewicz","sequence":"first","affiliation":[{"name":"Division of Anesthetic and Surgical Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, 51-618 Wroclaw, Poland"},{"name":"Department of Gastrointestinal Cancer, Lower Silesian Oncology, Hematology and Pulmonology Center, 53-413 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4292-161X","authenticated-orcid":false,"given":"Stanis\u0142aw","family":"Manulik","sequence":"additional","affiliation":[{"name":"Division of Healthcare Organization, Department of Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, 51-618 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3812-2869","authenticated-orcid":false,"given":"Anna","family":"Chudiak","sequence":"additional","affiliation":[{"name":"Division of Anesthetic and Surgical Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, 51-618 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Kr\u00f3wczy\u0144ska","sequence":"additional","affiliation":[{"name":"Cardinal Stefan Wyszynski Institute of Cardiology in Warsaw, 04-628 Warsaw, Poland"},{"name":"Department of Nursing and Obstetrics, Collegium Mazovia, 08-110 Siedlce, Poland"},{"name":"Department of Nursing, Faculty of Rehabilitation, J\u00f3zef Pi\u0142sudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Homola","sequence":"additional","affiliation":[{"name":"Gynaecology and Obstetrics Centre FemiMea, 55-040 Bielany Wroclawskie, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Pobrotyn","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Faculty of Medicine, Wroc\u0142aw University of Science and Technology, 51-377 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylwia","family":"Benirowska-Pomianowska","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, The Mazovian University in P\u0142ock, 09-402 P\u0142ock, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5734-116X","authenticated-orcid":false,"given":"Mariola","family":"G\u0142owacka","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, The Mazovian University in P\u0142ock, 09-402 P\u0142ock, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4296-7052","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Paprocka-Borowicz","sequence":"additional","affiliation":[{"name":"Department of Neurological Rehabilitation, Regional Specialist Hospital in Wroclaw, 51-128 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9232-4525","authenticated-orcid":false,"given":"Mariusz","family":"Chabowski","sequence":"additional","affiliation":[{"name":"Department of Surgery, 4th Military Teaching Hospital in Wroclaw, 50-981 Wroc\u0142aw, Poland"},{"name":"Department of Clinical Surgical Sciences, Faculty of Medicine, Wroclaw University of Science and Technology, 51-377 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Wu, S., Zhang, Y., Lin, Z., and Wei, M. 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