Preoperative Exercise Habits are Associated with Post‐gastrectomy Complications

Abstract

Background Sarcopenia is reportedly associated with postoperative complications of gastrectomy, which would presumably be affected by exercise habits aimed at maintaining muscle quantity and quality. However, the potential benefits of exercise habits have yet to be clarified. Methods We included 178 patients undergoing gastrectomy in this study. Postoperative complications above grade 2 according to the Clavien-Dindo classification were regarded as clinically significant. Patients were classified according to exercise quantity employing the International Physical Activity Questionnaire Short Form and relationships between exercise habits and complications were investigated. Results On univariate analysis, low exercise habits (p = 0.008) and total gastrectomy (p = 0.004) were significantly associated with morbidity after gastrectomy. Although severe comorbidity (p = 0.095) and combined resection (p = 0.064) tended to be associated with complications, multivariate analysis demonstrated only low levels of exercise (Odds ratio = 2.42, p = 0.014) and total gastrectomy (Odds ratio = 3.67, p = 0.028) to be independently associated with postoperative complications. Anastomotic leakage (p = 0.028) and systemic complications (p = 0.006), especially pneumonia, were significantly more frequent in the low exercise group. Conclusions Preoperative exercise habits independently affected short-term postoperative outcomes. Our results raise the possibility that exercise intervention would reduce the morbidity experienced by gastrectomy patients.

The 5‐factor modified frailty index is a novel predictive marker of death from other diseases after curative gastrectomy for gastric cancer

“…Preoperative rehabilitation might reduce postoperative complications after gastrectomy. 21,23 Preoperative smoking cessation and glycemic control might also decrease morbidities after gastrectomy. [24][25][26] Less-invasive surgery might also contribute to the reduction of post-gastrectomy morbidities.…”

Preoperative Low Physical Activity is a Predictor of Postoperative Delirium in Patients with Gastrointestinal Cancer: A Retrospective Study

“…Each intensity scores were assigned a metabolic equivalent (MET) value (e.g., METs for vigorous intensity = 8.0, moderate intensity = 4.0, and walking = 3.3), and patients were classified into three groups (e.g., high, moderate, and low) based on the IPAQ scoring protocol (Sjostrom et al, 2005). We then defined high and moderate as "active" and low as "inactive," according to a previous study (Toriumi et al, 2020).…”

Sarcopenia, muscle quality, and gastric cancer surgery

“…As general surgeons, there are possibilities for gastric cancer patients: exercise and operative procedure. We reported that a preoperative exercise habit could reduce post‐gastrectomy complications 3 . Preoperative 16‐day exercise programs with nutritional support for elderly sarcopenia patients with gastric cancer were shown to potentially diminish sarcopenia before surgery and improve postoperative outcomes 4 .…”