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Effect of an ERAS-based pulmonary rehabilitation exercise program on perioperative outcomes in liver resection
Lei Zhuang1, Xuqian Yang2, Ziyang Zhang2
1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Background:
Liver resection patients face a heightened risk of pulmonary complications and decreased quality of life during the perioperative period. The enhanced recovery after surgery (ERAS)-based pulmonary rehabilitation exercise program may offer potential benefits in mitigating these issues.
Aim:
This study aims to develop and evaluate the clinical effectiveness of an ERAS-based pulmonary rehabilitation exercise program for liver resection patients during the perioperative period.
Design:
A prospective, randomized controlled trial (RCT).
Setting:
A single-center study conducted in the Department of Hepatobiliary and Pancreatic Surgery at a tertiary hospital.
Population:
Patients undergoing liver resection for the first time between July 2024 and December 2024.
Methods:
This prospective study included patients who underwent liver resection for the first time in the Department of Hepatobiliary and Pancreatic Surgery of our hospital between July 2024 and December 2024. Patients were randomly assigned to either the intervention group (ERAS pulmonary rehabilitation exercise program) or the control group (routine rehabilitation care). Primary outcome measures included changes in pulmonary function indicators at postoperative days 1, 3, and 5. Secondary outcomes included changes in exercise function, postoperative complications, and other rehabilitation indicators.
Results:
A total of 202 patients were enrolled, with 100 in the intervention group and 102 in the control group. The intervention group showed significantly better improvements in pulmonary function indicators (FVC, FEV1, PEF, MEF75, and Borg score) on postoperative days 1, 3, and 5 compared to the control group. The time×group interaction effects were statistically significant (P<0.05). On postoperative day 5, the intervention group also demonstrated superior exercise capacity, grip strength, and ADL scores in the 6-minute walk test compared to the control group (P<0.05). Additionally, the incidence of postoperative complications, such as atelectasis and deep vein thrombosis, was lower in the intervention group (P<0.05). The intervention group had significantly shorter postoperative recovery times, including time to first bowel movement, time to first ambulation, antibiotic use, hospital stay, and hospitalization costs compared to the control group (P<0.05).
Conclusions:
The implementation of an ERAS-based pulmonary rehabilitation exercise program effectively promotes postoperative pulmonary recovery, reduces complications, and enhances activities of daily living, showing promising clinical applicability.
Clinical Rehabilitation Impact:
This study supports the integration of ERAS-based pulmonary rehabilitation into perioperative care for liver resection patients to enhance pulmonary function, accelerate recovery, and improve overall postoperative outcomes.
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