Importance of Initial Ambulation as a Factor Influencing Length of Hospital Stay after Surgery for Colorectal Cancer

Sachi HOKAMA; Chiemi UEHARA; Takuya FUKUSHIMA; Yuki NAKASHIMA; Tsuyoshi HARADA; Seiko KAMEYAMA

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Importance of Initial Ambulation as a Factor Influencing Length of Hospital Stay after Surgery for Colorectal Cancer

VernacularTitle:大腸がんの術後在院日数に影響する因子としての歩行開始日の意義
Author: Sachi HOKAMA ¹ ; Chiemi UEHARA ¹ ; Takuya FUKUSHIMA ² ; Yuki NAKASHIMA ³ ; Tsuyoshi HARADA ⁴ ; Seiko KAMEYAMA ⁵
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1. Department of Rehabilitation, Urasoe General Hospital
2. Faculty of Rehabilitation, Kansai Medical University
3. Department of Rehabilitation, Hiroshima University Hospital
4. Department of Rehabilitation Medicine, National Cancer Center Hospital East
5. Department of Rehabilitation Medicine, Urasoe General Hospital
Keywords: perioperative; early mobilization; early rehabilitation
From:The Japanese Journal of Rehabilitation Medicine 2024;():24006-
CountryJapan
Language:Japanese
Abstract: Objective：This study investigated whether the day of initial ambulation during rehabilitation affects postoperative outcomes in patients with colorectal cancer.Methods：This retrospective observational study was conducted at the Urasoe General Hospital. Patients who underwent scheduled surgery and requested preoperative rehabilitation between June 2019 and December 2021 were included in this study. Patient characteristics and surgery- and rehabilitation-related data were retrieved from the medical records. The patients were divided into early- and late-discharge groups according to their median postoperative hospital stay. The cut-off value of initial ambulation during the postoperative hospital stay was calculated, and logistic regression analysis was performed to determine the impact of initial ambulation on delayed postoperative hospital stay.Results：This study included 184 patients. The cutoff value for initial ambulation during the postoperative hospital stay was three days. In the univariate analysis, rectal cancer, operation time, blood loss, postoperative complications of Clavien-Dindo classification grade II or higher, and the initial ambulation day were identified as potentially significant factors. In the multivariate analysis, which included these potentially significant factors as input variables, postoperative complications, operation time, and the initial ambulation day were determined to be significant independent factors affecting postoperative hospital stay.Conclusion：The initial ambulation day can affect postoperative hospital stay in patients with colorectal cancer. It is important that the rehabilitation interventions undertaken after colorectal cancer surgery facilitate ambulation within the third postoperative day.