Clinical Impact of the Introduction of an Early Rehabilitation Protocol on Infectious Complications in Patients after Gastrointestinal Cancer Surgery.

BACKGROUND: The clinical importance of postoperative rehabilitation for cancer patients has recently attracted much attention. However, it remains uncertain whether early rehabilitation can prevent infectious complications in patients undergoing gastrointestinal cancer surgery.
METHODS: The study group consisted of 259 patients who underwent laparoscopic or open surgery for gastrointestinal cancer at our institution between December 2012 and November 2016. Our department proposed a new early rehabilitation protocol for such patients to encourage physical activity after surgery. The protocol was clinically introduced on July 21, 2015. We divided the study subjects into two groups: those who were admitted before the introduction of the new protocol and those admitted after. The frequency of infectious complications, including respiratory infections, and the length of hospital stay after surgery were compared between the two groups.
RESULTS: No adverse cardiovascular event associated with the early rehabilitation protocol was experienced. After the protocol was introduced, more than 80% of patients started exercising on the first day after surgery. For patients undergoing open surgery, the frequency of infectious complications was significantly reduced with the introduction of the protocol (p<0.05). Moreover, when open surgery was performed, the protocol significantly shortened the length of hospital stay (p<0.05).
CONCLUSION: Our proposed early rehabilitation protocol for patients who have undergone gastrointestinal cancer surgery was considered to be safe and feasible. The protocol may prevent infectious complications and shorten the hospital stay after such surgery. ©2019 The Japanese Association of Rehabilitation Medicine.