Association between Physical Activity and Postoperative Complications after Esophagectomy for Cancer: A Prospective Observational Study

Abstract

<b>Background:</b> Postoperative complications after esophagectomy can lead to considerable patient discomfortand prolonged length of hospital stay. Lack of physical activity can be one of the independent risk factors forpostoperative complications because physical activity is closely related to physical function. The objective ofthis study was to determine whether physical activity among esophageal cancer patients decreases their riskof postoperative complications after esophagectomy. Materials and <br/><b>Methods</b>: We investigated 51 consecutivepatients with newly diagnosed resectable esophageal cancer who were scheduled to receive esophagectomybetween January 2009 and November 2011. Demographic, clinicopathologic, and treatment information wererecorded and physical function was measured. The last 7-days short version of the International Physical ActivityQuestionnaire was used to assess physical activity before the operation. Stepwise multiple logistic regressionanalysis was used to determine whether preoperative physical activity is related to the risk of postoperativecomplications. <br/><b>Results</b>: Male gender [OR 18.6, (95%CIs: 1.2-284.4); P=0.035], 3-field lymph node dissection(OR 9.6, [95%CIs: 1.4-66.6]; P=0.022), low-level physical activity (OR 28.3, [95%CIs: 3.5-227.7]; P=0.002), andpreoperative comorbidities [OR 5.9, (95%CIs: 1.1-31.5); P=0.037] were found to be independently associated withpostoperative complications. <br/><b>Conclusions</b>: The present study shows that low-level physical activity, preoperativecomorbidities, and 3-field lymph node dissection are independent and significant risk factors for postoperativecomplications after esophagectomy. Although further study is required, maintaining high-level physical activitypreoperatively may decrease the risk of postoperative complications.