The effect of preoperative rehabilitation on the prevention of postoperative ileus in colorectal cancer patients
The effect of preoperative rehabilitation on the prevention of postoperative ileus in colorectal cancer patients
复制标题
术前康复对预防结直肠癌患者术后肠梗阻的影响
DOI：
10.1007/s00520-023-07585-x
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发表时间：
2023
影响因子：
3.1
通讯作者：
Momosaki Ryo
中科院分区：
文献类型：
--
作者：
Ushida Kenta;Yamamoto Yoshinori;Hori Shinsuke;Shimizu Miho;Kato Yuki;Toiyama Yuji;Okugawa Yoshinaga;Shimizu Akio;Momosaki Ryo
既往研究表明，结直肠癌患者的术前康复可以减少术后肠梗阻。然而，证据并不充分，还需要进一步研究。本研究旨在探讨短期的术前康复，无论是门诊还是住院，是否可以降低结直肠癌术后肠梗阻的发生率。包括接受手术和术后康复治疗的1-3期结直肠癌患者。比较接受短期术前康复治疗的患者和未接受短期康复治疗的患者术后肠梗阻的发生率。结果纳入476例符合条件的患者(女性占43.4%，平均年龄75.1 ± 10.9岁)，1914例(47.0%)接受了短期的术前康复治疗。术前康复组的术后肠梗阻发生率显著低于非康复组(调整前：5.5%比9.9%，p<； 0.001；调整后：5.2%比9.0%，p<； 0.001)。因此，术前康复与术后肠梗阻的发生率显著相关(OR：0.554，95%CI：0.415~0.739，p<； 0.001)。在对手术类型分组的校正分析中，在所有类型的手术中，术前康复组术后肠梗阻的发生率显著低于对照组。结论本研究表明，对1-3期结直肠癌患者进行短期的术前康复治疗，无论是住院患者还是门诊患者，术后肠梗阻的发生率均显著降低。
PurposePrevious research suggests that the preoperative rehabilitation of colorectal cancer patients can reduce postoperative ileus. However, the evidence is insufficient and further research is warranted. This study aimed to investigate whether short-term preoperative rehabilitation, both on an outpatient and inpatient basis, can reduce the incidence of postoperative ileus after colorectal cancer surgery.MethodsThis was a retrospective cohort study that drew on data from multicenter electronic medical records. Patients with stage 1–3 colorectal cancer who underwent surgery and postoperative rehabilitation were included. The incidence of postoperative ileus was compared between patients who received short-term preoperative rehabilitation and those who did not. Propensity score adjustment using inverse probability weighting and subgroup analysis by type of surgery was performed.ResultsFour thousand seventy-six eligible patients (43.4% female; mean age 75.1 ± 10.9 years) were included; 1914 (47.0%) received short-term preoperative rehabilitation. The preoperative rehabilitation group had a significantly lower incidence of postoperative ileus than the no preoperative rehabilitation group (pre-adjustment: 5.5% vs. 9.9%,p< 0.001; post-adjustment: 5.2% vs. 9.0%,p< 0.001). Therefore, preoperative rehabilitation was significantly associated with a lower incidence of postoperative ileus (OR: 0.554, 95% CI: 0.415–0.739,p< 0.001). In an adjusted analysis of surgery type subgroups, the incidence of postoperative ileus was significantly lower in the preoperative rehabilitation group for all types of surgery.ConclusionOur study showed that short-term preoperative rehabilitation for patients with stage 1–3 colorectal cancer, both with inpatients and outpatients, significantly reduces the incidence of postoperative ileus.