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Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2025; 17(11): 108345
Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.108345
Postoperative outcomes following prehabilitation vs no prehabilitation in elective colorectal surgery: A 2:1 propensity score-matched analysis
Kai Siang Chan, Priscilla Ng, Lynn Tan, Rachel E-Jing Soh, Boon Theng Tan, Yu Jing Ong, Joon Lan Chong, Surendra Kumar Mantoo, Yao Zong Lee, Kok-Yang Tan, Daniel Jin Keat Lee
Kai Siang Chan, Surendra Kumar Mantoo, Yao Zong Lee, Kok-Yang Tan, Daniel Jin Keat Lee, Department of General Surgery, Khoo Teck Puat Hospital, Singapore 768828, Singapore
Priscilla Ng, Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore 768828, Singapore
Lynn Tan, Rachel E-Jing Soh, Boon Theng Tan, Yu Jing Ong, Joon Lan Chong, Nursing Administration, Khoo Teck Puat Hospital, Singapore 768828, Singapore
Co-corresponding authors: Kai Siang Chan and Daniel Jin Keat Lee.
Author contributions: Chan KS contributed to analysis and interpretation of data, drafting the manuscript, and revising the manuscript; Ng P contributed to analysis and interpretation of data; Ng P, Tan KY, and Lee DJK contributed to conceptualization and supervision; Tan L, Soh REJ, Tan BT, Ong YJ, Chong JL, Mantoo SK, Lee YZ, Tan KY, and Lee DJK contributed to acquisition of data; Lee DJK contributed to revising the manuscript; All authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board of National Healthcare Group Domain Specific (Approval No. 2021/00967).
Informed consent statement: The requirement for informed consent was waived as the study was retrospective in nature and utilized a prospectively maintained database without the use of personally identifiable patient information.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data used in this study is not publicly available due to institutional policies. However, requests may be made to the corresponding author for access to de-identified data.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Siang Chan, Researcher, Department of General Surgery, Khoo Teck Puat Hospital, No. 90 Yishun Central, Singapore 768828, Singapore. kchan023@e.ntu.edu.sg
Received: April 14, 2025
Revised: June 20, 2025
Accepted: September 19, 2025
Published online: November 27, 2025
Processing time: 227 Days and 16.9 Hours
Core Tip

Core Tip: Aging is associated with frailty, increased comorbidities, and worse postoperative outcomes. Some studies on prehabilitation showed its potential in improving postoperative outcomes for elective colorectal surgery, but selection criteria and prehabilitation protocols are heterogeneous. Through propensity score matching, this study showed that prehabilitation in non-frail older patients (≥ 65 years) did not improve short-term outcomes and 1-year mortality. Open surgery was an independent predictor of 1-year mortality. Consideration should be made to modify and stratify the selection criteria for prehabilitation based on frailty scores and comorbidity burden to identify the group of patients who will best benefit given finite resources.