Postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trial

Abstract Background Early mobilization is an integral part of an enhanced recovery program after colorectal cancer surgery. The safety and efficacy of postoperative inpatient exercise are not well known. The primary objective was to determine the efficacy of a postoperative exercise program on posts...

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Main Authors: Jihee Min, Ki-yong An, Hyuna Park, Wonhee Cho, Hye Jeong Jung, Sang Hui Chu, Minsoo Cho, Seung Yoon Yang, Justin Y. Jeon, Nam Kyu Kim
Format: Article
Language:English
Published: BMC 2023-04-01
Series:BMC Gastroenterology
Subjects:
Online Access:https://doi.org/10.1186/s12876-023-02755-x
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author Jihee Min
Ki-yong An
Hyuna Park
Wonhee Cho
Hye Jeong Jung
Sang Hui Chu
Minsoo Cho
Seung Yoon Yang
Justin Y. Jeon
Nam Kyu Kim
author_facet Jihee Min
Ki-yong An
Hyuna Park
Wonhee Cho
Hye Jeong Jung
Sang Hui Chu
Minsoo Cho
Seung Yoon Yang
Justin Y. Jeon
Nam Kyu Kim
author_sort Jihee Min
collection DOAJ
description Abstract Background Early mobilization is an integral part of an enhanced recovery program after colorectal cancer surgery. The safety and efficacy of postoperative inpatient exercise are not well known. The primary objective was to determine the efficacy of a postoperative exercise program on postsurgical recovery of stage I–III colorectal cancer patients. Methods We randomly allocated participants to postoperative exercise or usual care (1:1 ratio). The postoperative exercise intervention consisted of 15 min of supervised exercise two times per day for the duration of their hospital stay. The primary outcome was the length of stay (LOS) at the tertiary care center. Secondary outcomes included patient-perceived readiness for hospital discharge, anthropometrics (e.g., muscle mass), and physical function (e.g., balance, strength). Results A total of 52 (83%) participants (mean [SD] age, 56.6 [8.9] years; 23 [44%] male) completed the trial. The median LOS was 6.0 days (interquartile range; IQR 5–7 days) in the exercise group and 6.5 days (IQR 6–7 days) in the usual-care group (P = 0.021). The exercise group met the targeted LOS 64% of the time, while 36% of the usual care group met the targeted LOS (colon cancer, 5 days; rectal cancer, 7 days). Participants in the exercise group felt greater readiness for discharge from the hospital than those in the usual care group (Adjusted group difference = 14.4; 95% CI, 6.2 to 22.6; P < 0.01). We observed a small but statistically significant increase in muscle mass in the exercise group compared to usual care (Adjusted group difference = 0.63 kg; 95% CI, 0.16 to 1.1; P = 0.03). Conclusion Postsurgical inpatient exercise may promote faster recovery and discharge after curative-intent colorectal cancer surgery. Trial registration The study was registered at WHO International Clinical Trials Registry Platform (ICTRP; URL http://apps.who.int/trialsearch ); Trial number: KCT0003920 .
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spelling doaj.art-889564e7088c4a8c99141469a41e4aa52023-04-23T11:19:13ZengBMCBMC Gastroenterology1471-230X2023-04-012311910.1186/s12876-023-02755-xPostoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trialJihee Min0Ki-yong An1Hyuna Park2Wonhee Cho3Hye Jeong Jung4Sang Hui Chu5Minsoo Cho6Seung Yoon Yang7Justin Y. Jeon8Nam Kyu Kim9National Cancer Survivorship Center, National Cancer Control Institute, National Cancer CenterFaculty of Kinesiology, Sport, and Recreation, University of AlbertaNational Cancer Survivorship Center, National Cancer Control Institute, National Cancer CenterNational Cancer Survivorship Center, National Cancer Control Institute, National Cancer CenterDepartment of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei UniversityDepartment of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei UniversityDepartment of Surgery, Yonsei University College of MedicineDepartment of Surgery, Yonsei University College of MedicineNational Cancer Survivorship Center, National Cancer Control Institute, National Cancer CenterDepartment of Surgery, Yonsei University College of MedicineAbstract Background Early mobilization is an integral part of an enhanced recovery program after colorectal cancer surgery. The safety and efficacy of postoperative inpatient exercise are not well known. The primary objective was to determine the efficacy of a postoperative exercise program on postsurgical recovery of stage I–III colorectal cancer patients. Methods We randomly allocated participants to postoperative exercise or usual care (1:1 ratio). The postoperative exercise intervention consisted of 15 min of supervised exercise two times per day for the duration of their hospital stay. The primary outcome was the length of stay (LOS) at the tertiary care center. Secondary outcomes included patient-perceived readiness for hospital discharge, anthropometrics (e.g., muscle mass), and physical function (e.g., balance, strength). Results A total of 52 (83%) participants (mean [SD] age, 56.6 [8.9] years; 23 [44%] male) completed the trial. The median LOS was 6.0 days (interquartile range; IQR 5–7 days) in the exercise group and 6.5 days (IQR 6–7 days) in the usual-care group (P = 0.021). The exercise group met the targeted LOS 64% of the time, while 36% of the usual care group met the targeted LOS (colon cancer, 5 days; rectal cancer, 7 days). Participants in the exercise group felt greater readiness for discharge from the hospital than those in the usual care group (Adjusted group difference = 14.4; 95% CI, 6.2 to 22.6; P < 0.01). We observed a small but statistically significant increase in muscle mass in the exercise group compared to usual care (Adjusted group difference = 0.63 kg; 95% CI, 0.16 to 1.1; P = 0.03). Conclusion Postsurgical inpatient exercise may promote faster recovery and discharge after curative-intent colorectal cancer surgery. Trial registration The study was registered at WHO International Clinical Trials Registry Platform (ICTRP; URL http://apps.who.int/trialsearch ); Trial number: KCT0003920 .https://doi.org/10.1186/s12876-023-02755-xExerciseColectomyColorectal cancerPost-operativeLength of stayPatient-perceived readiness for hospital discharge
spellingShingle Jihee Min
Ki-yong An
Hyuna Park
Wonhee Cho
Hye Jeong Jung
Sang Hui Chu
Minsoo Cho
Seung Yoon Yang
Justin Y. Jeon
Nam Kyu Kim
Postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trial
BMC Gastroenterology
Exercise
Colectomy
Colorectal cancer
Post-operative
Length of stay
Patient-perceived readiness for hospital discharge
title Postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trial
title_full Postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trial
title_fullStr Postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trial
title_full_unstemmed Postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trial
title_short Postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trial
title_sort postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients a randomized controlled trial
topic Exercise
Colectomy
Colorectal cancer
Post-operative
Length of stay
Patient-perceived readiness for hospital discharge
url https://doi.org/10.1186/s12876-023-02755-x
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