A new parameter for assessing postoperative recovery of physical activity using an accelerometer.
OBJECTIVE
While many retrospective and prospective observational studies have shown laparoscopic surgery to be less invasive than conventional open surgery, this issue has not been evaluated by objective parameters. Currently available clinical parameters, such as the day of first ambulation, the day food intake is commenced, and the length of postoperative hospital stay, are subjective. The purpose of this study was to investigate whether measuring postoperative physical activity with an accelerometer is a useful parameter for evaluating postoperative recovery after surgical stress.


METHODS
The subjects included 20 patients who underwent laparoscopic partial gastrectomy (LPG group), 35 patients who underwent open distal gastrectomy (ODG group), and 20 patients who underwent open total gastrectomy (OTG group). The cumulative acceleration of voluntary movement, measured by an Active tracer AC-301 (ACT) accelerometer for 7 days postoperatively, was compared among these three groups.


RESULTS
The cumulative acceleration of physical activity for 24 h was significantly better in the LPG group than in the ODG and OTG groups on each postoperative day. The recovery time, defined as the day that cumulative acceleration had recovered to more than 90% of the preoperative level, was significantly shorter in the LPG group (2.8 +/- 0.9 days) than in the ODG (6.6 +/- 2.1 days) and OTG (7.8 +/- 1.2 days) groups.


CONCLUSIONS
These results showed that convalescence differed with the degree of surgical stress, and that measurement of the cumulative acceleration of voluntary movement by using an accelerometer could be a useful objective and quantitative parameter for evaluating postoperative recovery.
Inouez
Yoshifumiz
Y
Department of Surgery, Nissay Hospital, 6-3-8 Itachibori, Nishi-ku, Osaka 550-0012, Japan.
Kimura
Toshihiro
T
Fujita
Shigeo
S
Noro
Hiroshi
H
Nishikawa
Kazuhiro
K
Yumiba
Takeyoshi
T
Taniguchi
Eiji
E
Ohashi
Shuichi
S
Yoshida
Shogo
S
Matsuda
Hikaru
H
D000368:Aged; D023381:Endpoint Determination; D004867:Equipment Design; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation; D009068:Movement; D010807:Physical Endurance; D011183:Postoperative Complications; D011184:Postoperative Period