FTP3.8 Are we doing enough to get patients moving after colorectal cancer surgery?

Abstract

Abstract Background Enhanced recovery after surgery (ERAS) is a widely implemented, multi-disciplinary pathway designed to reduce perioperative stress, maintain postoperative physiological function and accelerate recovery after surgery. Postoperative movement, as advocated by ERAS, reduces postoperative muscle wasting and the risk of complications such as chest infections and ileus and should be encouraged in all colorectal cancer patients. Methods Nine adult patients undergoing elective colorectal cancer resection had their physical activity assessed using an ActivPAL™ accelerometer applied to the anterior right thigh from the first postoperative day for 7 days or until discharge (if sooner). Time in bed and step count was collected. Results Patient age ranged from 54-87 years (median = 71). Mode of access included laparoscopy (n=7), robotic (n=1) and open (n=1), and no patients required intensive care postoperatively. The median length of hospital stay was 6 days (interquartile range (IQR): 3 days) and patients wore the accelerometer for a median time of 6 days (IQR: 2 days). The median step count on postoperative days 1, 3 and 5 was 128 (IQR: 236), 506 (IQR: 532) and 438 (IQR: 1256) steps/day, respectively. The median time spent in bed was 10 (IQR: 2.2), 10 (IQR: 8.5) and 9 (3.4) hours, respectively. Conclusions Even in those patients engaged in an ERAS programme, time spent performing physical activity is variable and does not appear to increase during the postoperative inpatient period. Step count targets may be a useful goal setting, patient-led directive to improve the consistency of postoperative mobilisation.