Authors (including presenting author) :
Tam KL(1), Chan WY(1), Cheung TK(1), Cheung KY(1), Wong SW(1), Szeto YL(1), Tsang HC(1), To YL(1), Luk WY(2), Ng CK(2), Sun TF(3)
Affiliation :
(1) Physiotherapy department, North District Hospital, (2) Surgery department, North District Hospital, (3) Hospital Chief Executive office, North District Hospital
Introduction :
A Perioperative program for colorectal cancer patients was launched since October 2019 to enhance recovery of patients and reduce post-operative complications. Conventional physiotherapy only provided referral-based physiotherapy service after surgery, whereas perioperative program started physiotherapy intervention before surgery. It consisted of two components which included pre-operative prehabilitation and post-operative intensive physiotherapy service. Patients scheduled for colorectal surgeries were referred to physiotherapy department. Those with higher risk of post-operative complications were triaged to prehabilitation program which consisted of pre-operative education, breathing technique training, supervised aerobic exercise and strengthening exercise training with home exercise prescription. After receiving colorectal surgery, immediate chest physiotherapy was provided at post-operation day 0. Chest physiotherapy service were provided twice daily at post-operation day 1 and 2 with early out of bed mobilization as patient tolerated. Besides conventional holiday chest physiotherapy, additional out of bed mobilization service was provided to indicated patients.
Objectives :
To shorten length of stay by enhancing recovery for patients undergone elective colorectal surgery.
Methodology :
Colorectal cancer patients who had prehabilitation training from October 2019 to September 2021 were categorized as intervention group. Equal number of patients undergone elective colorectal surgery before the commencement of perioperative physiotherapy program were randomly selected as the control group. Length of stay (LOS), and the incidence of post-operative pneumonia and venous thromboembolism between two groups were compared.
Result & Outcome :
A total of 25 patients with mean age of 69.6 (range: 57-84) completed prehabilitation and received elective colorectal surgery since October 2019. 25 patients with mean age of 65.8 (range: 46-87) who received elective colorectal surgery with convention physiotherapy service were randomly selected as the control group. The median length of stay was 8 days in intervention group which was 1 day less than the median length of stay of the control group (median: 9 days). No episode of post-operative pneumonia and venous thromboembolism was reported in both intervention group and control group. No adverse effect of perioperative program was reported.
Conclusion:
Perioperative Physiotherapy Program is safe and effective in shortening length of stay and preventing post-operative complications in patients undergoing elective colorectal surgeries.
