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How Many Steps Per Day are Necessary to Prevent Postoperative Complications Following Hepato-Pancreato-Biliary Surgeries for Malignancy?

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The current study was designed to investigate the association between the average preoperative physical activity and postoperative outcomes in patients undergoing surgeries for hepato-pancreato-biliary (HPB) malignancy.

Methods

Patients who were scheduled to undergo open abdominal surgeries for HPB malignancies (major hepatectomy, pancreatoduodenectomy, or hepato-pancreatoduodenectomy) between 2016 and 2017 were included. The average steps per day were recorded by a pedometer and calculated for each patient during the preoperative waiting period. Physical activity levels were classified according to the average number of daily steps as poor (< 5000 steps/day) and good (≥ 5000 steps/day).

Results

Of the 105 eligible patients, 78 met the inclusion criteria. The median number of steps per day was 6174. There were 48 patients (62%) with good physical activity and 30 patients (38%) with poor physical activity. Patients with poor physical activity revealed a significantly higher rate of major complications with Clavien grade ≥ 3 (63% vs. 35%, p = 0.016), a higher rate of infectious complications (53% vs. 23%, p = 0.006), and a longer postoperative hospital stay (median, 30 vs. 21 days, p < 0.001) compared with those with good physical activity. After a multivariate analysis, poor physical activity was identified as an independent risk factor for the development of major complications (odds ratio, 2.842, p = 0.042) and infectious complications (odds ratio, 3.844, p = 0.007).

Conclusions

The current study demonstrated that preoperative physical activity levels are associated with the incidence of major postoperative complications following HPB surgery for malignancy.

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Acknowledgment

This work was supported in part by a Grant (No. H29-B31 to H. Nakajima) from the Japanese Physical Therapy Association. The authors sincerely thank all of the patients, collaborating physicians, and other medical staff for their important contributions to this study.

Disclosure

The authors affirm that they have no financial or personal affiliations (including research funding) or other involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript.

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Authors and Affiliations

  1. Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan

    Hiroki Nakajima PT, Takayuki Inoue PT, PhD, Motoki Nagaya PT, MSc, Yota Mizuno PT, Azusa Kayamoto PT & Yoshihiro Nishida MD

  2. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

    Yukihiro Yokoyama MD & Masato Nagino MD

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  1. Hiroki Nakajima PT
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  2. Yukihiro Yokoyama MD
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  3. Takayuki Inoue PT, PhD
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Correspondence to Yukihiro Yokoyama MD.

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Supplementary Fig.

 1 Leaflet used for guiding patients. Supplementary Fig. 2 Correlation plots for physical activity and preoperative serum albumin (DOCX 252 kb)

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Nakajima, H., Yokoyama, Y., Inoue, T. et al. How Many Steps Per Day are Necessary to Prevent Postoperative Complications Following Hepato-Pancreato-Biliary Surgeries for Malignancy?. Ann Surg Oncol 27, 1387–1397 (2020). https://doi.org/10.1245/s10434-020-08218-x

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  • DOI: https://doi.org/10.1245/s10434-020-08218-x

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