title: Perioperative exercise for chronic liver injury patients with hepatocellular carcinoma undergoing hepatectomy.
abstract: BACKGROUND
  The aim of this study was to examine the outcomes of exercise therapy in patients with hepatocellular carcinoma who underwent hepatectomy.
  
  
  METHODS
  Fifty-one patients with hepatocellular carcinoma were randomized to diet therapy alone (n = 25) or to exercise in addition to diet therapy (n = 26). Exercise at the anaerobic threshold of each patient was started 1 month preoperatively, resumed from 1 week postoperatively, and continued for 6 months.
  
  
  RESULTS
  Whole body mass and fat mass in the exercise group compared with the diet group were significantly decreased at 6 months postoperatively. Fasting serum insulin and the homeostasis model assessment score were also significantly decreased. At 6 months, anaerobic threshold and peak oxygen consumption were significantly increased, while serum insulin and insulin resistance were significantly improved in a high-frequency exercise subgroup compared with a low-frequency group.
  
  
  CONCLUSIONS
  Perioperative exercise therapy for patients with hepatocellular carcinoma with liver dysfunction may improve insulin resistance associated with hepatic impairment and suggests a benefit to the early resumption of daily exercise after hepatectomy.
authors: Department of Surgery, Hirakata Hospital, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan. kaibori@hirakata.kmu.ac.jp
authors: Masaki
authors: M
authors: Kaibori
authors: Morihiko
authors: M
authors: Ishizaki
authors: Kosuke
authors: K
authors: Matsui
authors: Richi
authors: R
authors: Nakatake
authors: Sawako
authors: S
authors: Yoshiuchi
authors: Yutaka
authors: Y
authors: Kimura
authors: A-Hon
authors: AH
authors: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000178:diet therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D002908:Chronic Disease; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D016896:Treatment Outcome
keywords: Cirrhosis; Exercise; Hepatectomy; Insulin resistance; Liver cancer