Postoperative Exercise In Gastrectomy Gastric Cancer Patients. A Randomized Controlled Trial

BACKGROUND: Faster physical recovery after gastrectomy may lead to better physical and psychological health in patients with gastric cancer. Post-surgical exercise interventions could lead to faster recovery from surgery and prevent physical dysfunction. The effect of these interventions on physical function in this patient group is yet to be fully explored. PURPOSE: This study examines the impact of postoperative exercise on the physical recovery of gastric cancer patients (Stages 1-3). METHOD: In this trial, 52 patients were randomly assigned to postoperative exercise or usual care (1:1 ratio). The in-patient post-operative intervention involved 15 minutes of supervised resistance exercise and encouraging walking on postoperative days (POD) 1 and 2. After discharge intervention involved two remote exercises and instructed 30 minutes of low to moderate-intensity walking and daily bodyweight exercises. Measurements were taken three times (baseline, POD3, and the first outpatient visit 1 month after surgery). The primary outcome was a Short Physical Performance Battery (SPPB), with secondary outcomes including grip strength, 30-second sit-to-stand (STS), body composition, and C-reactive protein (CRP). RESULT: A total of 44 (85%) participants (mean [SD] age, 60.3 [12.41] years; 25 [57%] male) completed the trial. Compliance with intervention in-patient exercise was 96% and remote exercise was 79%. The significant difference in SPPB scores of 11.4±1.3 in the exercise group compared with 10.7±1.43 usual care group (mean difference, -1.09 score; 95%CI, -1.7 to -0.4; p=<.001). Moreover, there were significant differences between groups in the STS exercise group 14.3±2.8 usual care group 13.6±4.5 (mean difference, 1.86; 95%CI, -3.3 to -0.4; p=.014), and CRP in POD3 exercise group 66.9±40.73 usual care group 103.7±54.25 (mean difference, -22.54 score; 95%CI, -46.5 to 1.4; p=.015). However, there was no significant difference in grip strength and body composition. CONCLUSION: Exercise after subtotal gastrectomy can used as a treatment strategy to improve physical recovery for gastric cancer patients. Yonsei Signature Research Cluster Project (2023-22-0017 )