Tailored Exercise after Colorectal Cancer Surgery Accelerates Hospital Discharge and Physical Function Recovery
A research team led by Professor Justin Y. Jeon at Yonsei University and Professor Nam-kyu Kim at Yongin Severance Hospital, Yonsei University
Published in BMC Gastroenterology, an international journal in gastroenterology
[Prof. Nam Kyu Kim, Jihee Min, Prof. Justin Y. Jeon, from left]
Professor Justin Y. Jeon at the Department of Sport Industry Studies, College of Educational Sciences, Yonsei University, and Professor Nam-kyu Kim at Yongin Severance Hospital, Yonsei University, published the results of a significant study that demonstrated that tailored exercise after surgery accelerates the recovery of colorectal cancer patients and reduces their length of hospital stay.
When patients diagnosed with colorectal cancer (colon and rectal cancer) receive surgery for complete or partial remission of the tumor, they are hospitalized for about 5‒7 days after surgery to focus on required medical care and recovery. As patients’ recovery after surgery is closely linked to not only medical cost but also prognosis for further treatment, many clinicians are developing clinical pathways (CPs) to accelerate patient recovery.
CPs serve as a plan of care that provides decisions and criteria for diagnosing, managing, and treating diseases. For colorectal cancer, they provide a combination of nutrition, pain control, and other care to help patients recover more quickly after surgery. Walking is the exercise recommended most often by clinicians. Previous studies, however, reported that walking does not have a significant effect on postoperative recovery for gastrointestinal cancer patients.
To find an exercise that is safe yet helps patients recover after surgery, Professor Jeon’s research team and Professor Kim at Yongin Severance Hospital collaborated to develop an exercise program as a CP for postoperative colorectal cancer patients and determine its clinical effect.
A total of 52 patients with Stage 1‒3 colorectal cancer participated in the study; the exercise group performed 15 minutes of exercise tailored by the exercise specialist according to patients’ recovery status every morning and evening from the first day after surgery until the day of hospital discharge. A remarkable effect of 30 minutes of exercise a day was observed in colorectal cancer patients during their hospital stay. The exercise group stayed in the hospital about one day less than the control group and was nearly twice as likely to reach their target length of hospital stay under the CP (5 days after colon cancer surgery and 7 days after rectal cancer surgery) (64.3% in the exercise group vs. 35.7% in the control group). No significant difference in postoperative side effects was observed between the groups. Furthermore, the exercise group showed a higher score in patient-perceived readiness for hospital discharge (Pt-RHDS) compared with the control group during hospital stay (mean 82.5±16.9 in the exercise group vs. mean 68.5±22.3 in the control group), and the exercise group showed improvements in body composition and strength.
Professor Jeon’s research team (first author Jihee Min) found that an evidence-based exercise program for colorectal cancer patients had a significant effect on accelerating patients’ recovery. These results are profound, suggesting that the light-intensity strength exercise that can be performed in bed and while sitting down not only prevents patients’ declining physical function and muscle loss but also shortens their hospital stay and improves their condition at the time of hospital discharge.
The results are expected to serve as an important reference for clinicians and patients who are reluctant to perform the necessary exercise because of a lack of evidence about the type and manner of exercise after surgery and whether it is safe.
This study was conducted as a part of the Yonsei Signature Research Cluster Project, and the results were published on April 17 in BMC Gastroenterology, an international journal in the field of gastroenterology.
Professor Hyuk-Jae Chang
Professor Sung-Joo Hwang
Professor Dae Hyun Lew