PERIOPERATIVE EXERCISE FOR CIRRHOSIS PATIENTS WITH HEPATOCELLULAR CARCINOMA UNDERGOING HEPATECTOMY

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Abstract

Background

Little is known about the role of exercise in the management of hepatectomy, so the efficacy of exercise therapy was examined in cirrhosis patients with hepatocellular carcinoma (HCC) undergoing hepatectomy.

Methods

The subjects were HCC patients with chronic hepatitis or cirrhosis. The diet group (n = 25) received diet alone and the exercise group (n = 26) received exercise combined with diet. Exercise was started 1 month preoperatively, resumed from 1 week postoperatively, and continued for 6 months at the anaerobic threshold (AT) of each patient. Parameters were evaluated by using exercise testing, whole body dual energy X-ray absorptiometry, and biochemistry tests.

Results

The whole body mass and fat mass of the exercise group were significantly decreased at 6 months postoperatively. Fasting serum insulin and the homeostasis model assessment score (an index of insulin resistance) were also significantly decreased. The exercise group was divided into standard and high frequency subgroups that exercised 3 and 5–6 times/week, respectively. At 6 months, AT and peak oxygen consumption were significantly increased, while whole body mass and fat mass were significantly decreased in the high-frequency subgroup. Both serum insulin and insulin resistance were also significantly improved.

Conclusions

Perioperative exercise therapy for HCC patients with liver dysfunction may improve insulin resistance associated with hepatic impairment, maintain physical strength, and promote early resumption of daily activities after hepatectomy.

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