Perioperative exercise for chronic liver injury patients with hepatocellular carcinoma undergoing hepatectomy

• Published in: The American journal of surgery Vol. 206; no. 2; pp. 202 - 209
• Main Authors: Kaibori, Masaki, M.D, Ishizaki, Morihiko, M.D, Matsui, Kosuke, M.D, Nakatake, Richi, M.D, Yoshiuchi, Sawako, R.D, Kimura, Yutaka, M.D, Kwon, A-Hon, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2013; Elsevier Limited
• Subjects: Adult; Aged; Bone density; Carcinoma, Hepatocellular - diet therapy; Carcinoma, Hepatocellular - etiology; Carcinoma, Hepatocellular - surgery; Carcinoma, Hepatocellular - therapy; Chronic Disease; Cirrhosis; Diet; Exercise; Exercise Therapy; Female; Hepatectomy; Humans; Insulin Resistance; Liver cancer; Liver cirrhosis; Liver Cirrhosis - complications; Liver Neoplasms - etiology; Liver Neoplasms - surgery; Liver Neoplasms - therapy; Male; Middle Aged; Perioperative Period; Surgery; Treatment Outcome; Japan; Liver cancer; Cirrhosis; Insulin resistance; Exercise; Hepatectomy
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2012.07.035

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.