Effects of different rehabilitation strategies on physical function and complications in postoperative patients with esophageal cancer: a systematic review and meta-analysis.

The results indicated that: Preoperative-only rehabilitation reduced hospital stay by −2.94 days [95% CI (−5.50, −0.37)], with moderate heterogeneity ( I 2 = 84%) and borderline significance (Z = 2.24, p = 0.02); Postoperative-only rehabilitation demonstrated a significant benefit [MD = −1.39 days, 95% CI (−1.74, −1.03), p < 0.00001], with low heterogeneity ( I 2 = 40%); Comprehensive perioperative rehabilitation yielded the largest reduction [MD = −3.01 days, 95% CI (−4.42, −1.59), p < 0.0001], with high heterogeneity ( I 2 = 93%).

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Specifically, comprehensive rehabilitation showed a strong trend toward reduced pneumonia risk in open surgery [RR = 0.66, 95% CI (0.40, 1.07), p = 0.09], whereas no discernible effect was observed in MIE patients [RR = 0.96, 95% CI (0.64, 1.44), p = 0.85].

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Postoperative-only interventions did not reach statistical significance [SMD = 0.31, 95% CI (−1.08, 1.70), p = 0.66], although the direction favored the experimental group.

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Although the point estimate was slightly attenuated compared to the main analysis (MD = −2.49), the effect remained clinically meaningful and highly significant.

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