Safety of ultra-early postoperative activity after laparoscopic radical hysterectomy for cervical cancer

Abstract

Objective To investigate the safety of the ultra-early (0~6 h) activity program for patients after minimally invasive radical treatment of cervical cancer. Methods A non-randomized concurrent controlled trial was conducted on 118 patients undergoing minimally invasive radical surgery for cervical cancer in our department from June to December 2019. According to patient's wish, they were divided into the ultra-early (0~6 h) postoperative activity group (n=58) and the conventional activity group (n=60). The patients in both groups received the perioperative program of rapid gynecological rehabilitation. After the operation, the conventional activity group adopted the conventional nursing plan, and the ultra-early activity group adopted the ultra-early postoperative activity plan according to the characteristics of patients with one-to-one guidance and assistance by professional health education nurses. If a patient suffered from conscious weakness, palpitation, dizziness, pale or cold sweats, oxygen saturation < 94%, or heart rate reaching the target heart rate of Karvonen formula, the activity program would be stopped immediately when any of them presented. Results The time to get out of bed for the first time and the activity scores were better in the ultra-early activity group than the conventional activity group (P=0.011). There were no statistically significant differences in SpO2, pulse, pain scores, and incidence of complications between the 2 groups before and after activities. The ultra-early activity group had obviously better average activity in 3 d post-operatively during hospitalization (P=0.000), shorter times to first postoperative exhaust (P=0.020) and to first oral feeding (P=0.010), and shorter length of hospital stay (P=0.010) when compared with the conventional activity group. Conclusion All patients in the ultra-early activity group are able to get out of bed within 24 h post-operatively, and attain better activity level in 3 d after operation than those of the conventional activity group. Ultra-early postoperative activity program can effectively improve the early out-of-bed activity rate after cervical cancer surgery and have no effect on the occurrence of postoperative complications.

Keywords

• cervical cancer
• rapid recovery
• early activity out of bed
• ultra-early activity (0~6 h)
• health education