Early ambulation after colorectal oncologic resection with perineal reconstruction is safe and effective

Nicholas A. Calotta, Devin O'Brien-Coon, Tobias J. Bos, Benjamin T. Ostrander, Andrew V. Scott, Michael C. Grant, Jonathan Efron, Justin Michael Sacks

Research output: Contribution to journalArticle

Abstract

Background: Post-operative bedrest is common following perineal reconstruction despite little supporting data. We sought to determine the safety of early ambulation following colorectal oncologic resection and flap-based perineal reconstruction. Methods: A retrospective cohort study was conducted with two cohorts: standard bedrest (BC) and early ambulation (EAC). Ambulation capacity was objectively assessed. Regression analysis was performed to determine the effects of ambulation timing on 60-day reoperations or readmissions and other surgical outcomes. Results: There were 57 participants. Those in the EAC were significantly more ambulatory on post-operative days one through three (p < 0.0001). There was no significant difference in 60-day reoperations (25% BC versus 9% EAC, p = 0.14) or readmissions (33% BC versus 15% EAC, p = 0.12). Early ambulation significantly reduced minor complication rates (38% BC versus 9% EAC, p = 0.02). Conclusions: Early ambulation following perineal reconstruction is safe and may potentially decrease wound complications. Summary and keywords: Institution of early ambulation protocols is rapidly becoming the standard of care for many oncological surgery patients. In cases requiring perineal reconstruction with vascularized flaps, however, there is no data to uproot the historical practice of mandatory bedrest. Our study demonstrates that the benefits of early ambulation are attainable in these patients without compromising reconstructive outcomes.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Early Ambulation
Bed Rest
Reoperation
Walking
Standard of Care
Cohort Studies
Retrospective Studies
Regression Analysis
Safety
Wounds and Injuries

Keywords

  • Early ambulation
  • Flap
  • Perineal reconstruction
  • Safety

ASJC Scopus subject areas

  • Surgery

Cite this

Early ambulation after colorectal oncologic resection with perineal reconstruction is safe and effective. / Calotta, Nicholas A.; O'Brien-Coon, Devin; Bos, Tobias J.; Ostrander, Benjamin T.; Scott, Andrew V.; Grant, Michael C.; Efron, Jonathan; Sacks, Justin Michael.

In: American Journal of Surgery, 01.01.2018.

Research output: Contribution to journalArticle

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abstract = "Background: Post-operative bedrest is common following perineal reconstruction despite little supporting data. We sought to determine the safety of early ambulation following colorectal oncologic resection and flap-based perineal reconstruction. Methods: A retrospective cohort study was conducted with two cohorts: standard bedrest (BC) and early ambulation (EAC). Ambulation capacity was objectively assessed. Regression analysis was performed to determine the effects of ambulation timing on 60-day reoperations or readmissions and other surgical outcomes. Results: There were 57 participants. Those in the EAC were significantly more ambulatory on post-operative days one through three (p < 0.0001). There was no significant difference in 60-day reoperations (25{\%} BC versus 9{\%} EAC, p = 0.14) or readmissions (33{\%} BC versus 15{\%} EAC, p = 0.12). Early ambulation significantly reduced minor complication rates (38{\%} BC versus 9{\%} EAC, p = 0.02). Conclusions: Early ambulation following perineal reconstruction is safe and may potentially decrease wound complications. Summary and keywords: Institution of early ambulation protocols is rapidly becoming the standard of care for many oncological surgery patients. In cases requiring perineal reconstruction with vascularized flaps, however, there is no data to uproot the historical practice of mandatory bedrest. Our study demonstrates that the benefits of early ambulation are attainable in these patients without compromising reconstructive outcomes.",
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AU - Calotta, Nicholas A.

AU - O'Brien-Coon, Devin

AU - Bos, Tobias J.

AU - Ostrander, Benjamin T.

AU - Scott, Andrew V.

AU - Grant, Michael C.

AU - Efron, Jonathan

AU - Sacks, Justin Michael

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