Cho Haruhiko, Yoshikawa Takaki, Oba Mari S, Hirabayashi Naoki, Shirai Junya, Aoyama Toru, Hayashi Tsutomu, Yamada Takanobu, Oba Koji, Morita Satoshi, Sakamoto Junichi, Tsuburaya Akira
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan,
Ann Surg Oncol. 2014 Jun;21(6):2044-50. doi: 10.1245/s10434-013-3394-7. Epub 2014 Mar 27.
Because obesity is a risk factor during surgery, the effects of a preoperative exercise program to reduce the incidence of peri- and postoperative complications in patients with a high body mass index (>25 kg/m(2)) and metabolic syndrome were investigated. An assessment of the effects of prospectively planned preoperative exercise was performed in a prospective matching study comparing an exercise testing group and a usual preoperative preparation group who underwent gastrectomy for gastric cancer in Japan.
Stage I gastric cancer patients with metabolic syndrome diagnosed according to the criteria of the Japanese Ministry of Health, Labor, and Welfare underwent surgery after preoperative exercise. The control group was selected from a database using an individual matching approach for surgery, sex, weight, body mass index, volume of visceral fat, and institution. The primary end point was the frequency of postoperative complications such as cardiovascular events, pneumonia, and surgery-related abdominal complications.
Data from a total of 72 patients (54 in the surgery-alone group, 18 in the preoperative exercise group) were analyzed. The median operative time and amount of bleeding were 208 min and 130 ml in the surgery-alone group and 248 min and 105 ml in the exercise group, respectively. Postoperative complications occurred in one case (5.5 %) in the exercise group and 22 (40.7 %) cases in the surgery-alone group.
Preoperative exercise is safe, and its benefits in reducing postoperative complications are promising and therefore warrant further investigation.
由于肥胖是手术期间的一个风险因素，因此研究了术前运动计划对降低高体重指数（>25 kg/m²）和代谢综合征患者围手术期及术后并发症发生率的影响。在一项前瞻性匹配研究中，对日本接受胃癌胃切除术的运动测试组和常规术前准备组进行了前瞻性计划的术前运动效果评估。
根据日本厚生劳动省的标准诊断为代谢综合征的I期胃癌患者在术前运动后接受手术。对照组通过个体匹配方法从数据库中选取，匹配因素包括手术、性别、体重、体重指数、内脏脂肪量和机构。主要终点是术后并发症的发生率，如心血管事件、肺炎和手术相关的腹部并发症。
共分析了72例患者的数据（单纯手术组54例，术前运动组18例）。单纯手术组的中位手术时间和出血量分别为208分钟和130毫升，运动组分别为248分钟和105毫升。运动组有1例（5.5%）发生术后并发症，单纯手术组有22例（40.7%）发生术后并发症。
术前运动是安全的，其在降低术后并发症方面的益处很有前景，因此值得进一步研究。
