Preoperative Improvement in Physical Function by Comprehensive Rehabilitation Leads to Decreased Postoperative Complications in Gastrointestinal Cancer Patients

Abstract

OBJECTIVES: The aim of this study was to investigate how baseline laboratory data and changes in physical function due to preoperative rehabilitation training in gastrointestinal cancer (GIC) patients can influence the frequency of postoperative complications (PCs). METHODS: We enrolled 45 patients who were scheduled for elective surgery for GIC (27 men and 18 women, mean age 63.6±9.5 years). All patients underwent a medical examination and received general instruction from a rehabilitation physician and exercise instruction from a physical therapist from 7 to 34 days before the surgery. PCs were graded using the Clavien-Dindo classification based on the medical records 1 month postoperatively. We measured the grip strength and the isometric knee extension torque and conducted the 6-min walk test (6MWT) at baseline and just before surgery. The surgical duration, blood loss, and blood transfusion data were collected. Baseline laboratory information, including C-reactive protein levels, serum albumin levels, platelet count, white blood cell count, and the estimated glomerular filtration rate, was recorded. RESULTS: The frequency of PCs was negatively correlated to the change in the 6MWT (β=-0.36) and positively correlated to the surgical duration (β=0.41). Baseline albumin was positively correlated to the change in the 6MWT distance (β=0.35). This model demonstrated an acceptable fit to the data (goodness of fit index=0.980, comparative fit index=1.000, root mean square error of approximation=0.000). CONCLUSIONS: The improvement of gait ability achieved with preoperative rehabilitation training in patients undergoing elective GIC surgery led to decreased PCs.