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

Nicholas A. Calotta, Devin Coon, Tobias J. Bos, Benjamin T. Ostrander, Andrew V. Scott, Michael C. Grant, Jonathan E. Efron, Justin M. Sacks

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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
Pages (from-to)125-130
Number of pages6
JournalAmerican journal of surgery
Volume218
Issue number1
DOIs
StatePublished - Jul 2019

Keywords

  • Early ambulation
  • Flap
  • Perineal reconstruction
  • Safety

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