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Perioperative exercise for chronic liver injury patients with hepatocellular carcinoma undergoing hepatectomy
Kaibori M, Ishizaki M, Matsui K, Nakatake R, Yoshiuchi S, Kimura Y, Kwon A-H
American Journal of Surgery 2013 Aug;206(2):202-209
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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.
With permission from Excerpta Medica Inc.

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