title: Matched pair analysis to examine the effects of a planned preoperative exercise program in early gastric cancer patients with metabolic syndrome to reduce operative risk: the Adjuvant Exercise for General Elective Surgery (AEGES) study group.
abstract: BACKGROUND
  Because obesity is a risk factor during surgery, the effects of a preoperative exercise program to reduce the incidence of peri- and postoperative complications in patients with a high body mass index (>25 kg/m(2)) and metabolic syndrome were investigated. An assessment of the effects of prospectively planned preoperative exercise was performed in a prospective matching study comparing an exercise testing group and a usual preoperative preparation group who underwent gastrectomy for gastric cancer in Japan.
  
  
  METHODS
  Stage I gastric cancer patients with metabolic syndrome diagnosed according to the criteria of the Japanese Ministry of Health, Labor, and Welfare underwent surgery after preoperative exercise. The control group was selected from a database using an individual matching approach for surgery, sex, weight, body mass index, volume of visceral fat, and institution. The primary end point was the frequency of postoperative complications such as cardiovascular events, pneumonia, and surgery-related abdominal complications.
  
  
  RESULTS
  Data from a total of 72 patients (54 in the surgery-alone group, 18 in the preoperative exercise group) were analyzed. The median operative time and amount of bleeding were 208 min and 130 ml in the surgery-alone group and 248 min and 105 ml in the exercise group, respectively. Postoperative complications occurred in one case (5.5 %) in the exercise group and 22 (40.7 %) cases in the surgery-alone group.
  
  
  CONCLUSIONS
  Preoperative exercise is safe, and its benefits in reducing postoperative complications are promising and therefore warrant further investigation.
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan, choharuhiko@kcch.jp.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Cho
authors.forename: Takaki
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Mari S
authors.initials: MS
authors.lastname: Oba
authors.forename: Naoki
authors.initials: N
authors.lastname: Hirabayashi
authors.forename: Junya
authors.initials: J
authors.lastname: Shirai
authors.forename: Toru
authors.initials: T
authors.lastname: Aoyama
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hayashi
authors.forename: Takanobu
authors.initials: T
authors.lastname: Yamada
authors.forename: Koji
authors.initials: K
authors.lastname: Oba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Junichi
authors.initials: J
authors.lastname: Sakamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuburaya
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology; D016063:Blood Loss, Surgical; D005081:Exercise Therapy; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D061646:Operative Time; D010185:Pancreatic Fistula / Q000209:etiology*; D011014:Pneumonia / Q000209:etiology; D011300:Preoperative Care; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000209:etiology; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology