Impact of a multimodal prehabilitation program on postoperative recovery in patients undergoing total laparoscopic hysterectomy and its clinical effects on reducing the risk of venous thromboembolism occurrence
Abstract
Background Postoperative recovery and venous thromboembolism (VTE) are major concerns following total laparoscopic hysterectomy (TLH). This study aimed to evaluate the impact of a multimodal prehabilitation program on postoperative recovery and its clinical effects on reducing VTE risk in patients undergoing TLH. Methods This retrospective study involved 274 patients who underwent TLH for benign uterine diseases. Patients were divided into a conventional group (n = 145) and a prehabilitation group (n = 129). Postoperative recovery indicators, Caprini risk scores, lower extremity deep vein thrombosis (DVT) incidence, serum markers (coagulation function and inflammatory parameters), and complications were compared between groups. Results Compared with the conventional group, patients in the prehabilitation group demonstrated significantly shorter times to first anal exhaust (22.63 ± 4.38 vs. 24.47 ± 5.44 h, P = 0.002), first bowel movement (61.08 ± 6.23 vs. 63.26 ± 7.21 h, P = 0.008), first ambulation (18.45 ± 3.74 vs. 22.34 ± 4.09 h, P < 0.001), and postoperative hospital stay (4.39 ± 0.71 vs. 6.95 ± 1.03 days, P < 0.001). Postoperative pain scores at 6, 24, and 48 h were also significantly lower in the prehabilitation group (all P < 0.05). Additionally, the prehabilitation group showed improved postoperative Caprini risk profiles (P < 0.001) and significantly lower incidence of lower-extremity DVT (2.33% vs. 14.48%, P < 0.001). Coagulation function and inflammatory markers were also significantly improved in the prehabilitation group. Multivariate analysis further identified the prehabilitation program as an independent protective factor against postoperative DVT (OR = 0.223, 95%CI: 0.099–0.502, P < 0.001). Conclusion Multimodal prehabilitation significantly enhances postoperative recovery and reduces the risk of venous thromboembolism in patients undergoing TLH.