Wearable-measured early postoperative mobility is associated with recovery after elective colorectal cancer surgery: a prospective pilot study

Early mobilization is a key component of Enhanced Recovery After Surgery (ERAS) pathways following colorectal cancer surgery; however, objective postoperative mobility quantification remains limited. We evaluated whether early postoperative step counts measured using a wearable device could be associated with the achievement of ERAS-based discharge eligibility.

In this prospective pilot study, adults undergoing elective colorectal cancer resection at a single tertiary academic referral hospital wore a consumer wearable device (Galaxy Watch 5) from the day of surgery. Cumulative step counts on postoperative days (PODs) 1 and 2 were recorded. Discharge readiness was assessed daily by predefined ERAS criteria. The patients were dichotomized according to the median cumulative step count (3,781 steps). The primary endpoint was the achievement of ERAS-based discharge eligibility by POD 3, and the secondary endpoints included time to discharge readiness and postoperative length of stay.

Between August 2023 and December 2024, 38 patients were evaluated. Discharge readiness by POD 3 was more frequent in the active group (68.4% vs. 26.3%; odds ratio, 6.07; 95% confidence interval, 1.49-24.76; P=0.009), which achieved discharge readiness earlier (median, POD 3 vs. POD 4; P=0.003) and had a shorter postoperative stay (median, 5 days vs. 6 days; P=0.041) than did the inactive group. Early diet tolerance differed between the groups (P=0.013).

Higher early postoperative step counts were associated with earlier ERAS-based discharge readiness and shorter hospitalization. Wearable-derived mobility might provide an objective marker of recovery and target for postoperative mobilization strategies.