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

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. 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. 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. Preoperative exercise is safe, and its benefits in reducing postoperative complications are promising and therefore warrant further investigation.