Tetsuro Toriumi1, Hiroharu Yamashita2, Koichiro Kawasaki2, Yasuhiro Okumura2, Kotaro Wakamatsu2, Koichi Yagi2, Susumu Aikou2,3, Sachiyo Nomura2, Yasuyuki Seto2. 1. Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. toriumi-tky@umin.ac.jp. 2. Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. 3. Department of Bariatric and Metabolic Care, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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.
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.