Detailed Abstract
[E-poster - Biliary & Pancreas (Others(ERAS, Education etc.))]
[EP 114] Clinical Outcomes of Pre-and Postoperative Rehabilitation in Hepatobiliary Pancreatic Malignancy: Randomized Clinical Trial (PReHeBP)
Yejong PARK 1, Song Cheol KIM 1, Jae Hoon LEE 1, Ki Byung SONG 1, Ensung JUN 1, Woohyung LEE 1, Won KIM 1, Dae Wook HWANG 1
1 Division of Hepatobiliary And Pancreatic Surgery, Department of Surgery, Asan Medical Center, REPUBLIC OF KOREA, 2 Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, REPUBLIC OF KOREA, 3 Department of Rehabilitation Medicine, Asan Medical Center, REPUBLIC OF KOREA
Background : This study aims to investigate the effect of perioperative rehabilitation for patients undergoing surgery for hepatobiliary and pancreatic (HBP) malignancies, focusing on short-term outcomes, including quality of life.
Methods : In this single-center trial, we randomly assigned 136 adult patients into control and rehabilitation group with 78 patients in each, from 2016 through 2020. Of these, 121 patients withsurgery for HBP malignancies, 62 patients in rehabilitation and 59 in control, were included in intention-to-treat analysis. The primary outcome was the incidence and severity of surgical complications, and secondary outcomes were readmission rates, mortality incidence, changes in quality of life, and functional capacity up to three months after surgery.
Results : In the rehabilitation group, preoperative adherence was 75.8%, dropping to 50% postoperative at 3 months. The postoperative complication rates were 54.8% in the intervention and 38.9% in the control with no statistical significance (p=0.081). Complications of Clavien-Dindo Grade IIIa or higher were observed in 26.5% of the rehabilitation group and 20.5% of the control group, with no statistical significance. There were no significant differences in hospital stay, mortality, or readmission rate, as well as in the 6-minute walking test, muscle strength, balance, physical function, and quality of life measures across various functional and symptom scales.
Conclusions : Perioperative rehabilitation programs did not show an impact on postoperative complications and other general short-term outcomes in patients who underwent surgery for HBP malignancy. According to these results, it needs to develop a specific rehabilitation program for HBP surgery, and then large scale randomized controlled trials would be recommended.
Methods : In this single-center trial, we randomly assigned 136 adult patients into control and rehabilitation group with 78 patients in each, from 2016 through 2020. Of these, 121 patients withsurgery for HBP malignancies, 62 patients in rehabilitation and 59 in control, were included in intention-to-treat analysis. The primary outcome was the incidence and severity of surgical complications, and secondary outcomes were readmission rates, mortality incidence, changes in quality of life, and functional capacity up to three months after surgery.
Results : In the rehabilitation group, preoperative adherence was 75.8%, dropping to 50% postoperative at 3 months. The postoperative complication rates were 54.8% in the intervention and 38.9% in the control with no statistical significance (p=0.081). Complications of Clavien-Dindo Grade IIIa or higher were observed in 26.5% of the rehabilitation group and 20.5% of the control group, with no statistical significance. There were no significant differences in hospital stay, mortality, or readmission rate, as well as in the 6-minute walking test, muscle strength, balance, physical function, and quality of life measures across various functional and symptom scales.
Conclusions : Perioperative rehabilitation programs did not show an impact on postoperative complications and other general short-term outcomes in patients who underwent surgery for HBP malignancy. According to these results, it needs to develop a specific rehabilitation program for HBP surgery, and then large scale randomized controlled trials would be recommended.
SESSION
E-poster
E-Session 03/21 ALL DAY