J Gastric Cancer.  2018 Jun;18(2):118-133. 10.5230/jgc.2018.18.e12.

Feasibility and Effects of a Postoperative Recovery Exercise Program Developed Specifically for Gastric Cancer Patients (PREP-GC) Undergoing Minimally Invasive Gastrectomy

  • 1Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, Korea. wjhyung@yuhs.ac
  • 2Department of Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea.
  • 3Exercise Physiology Laboratory, Kookmin University, Seoul, Korea.
  • 4Medi Plus Solution, Seoul, Korea.
  • 5Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
  • 7Gastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea.
  • 8Sports, Health, and Rehabilitation Major, Kookmin University, Seoul, Korea.
  • 9Robot and MIS Center, Severance Hospital, Yonsei University Health System, Seoul, Korea.


Exercise intervention after surgery has been found to improve physical fitness and quality of life (QOL). The purpose of this study was to investigate the feasibility and effects of a postoperative recovery exercise program developed specifically for gastric cancer patients (PREP-GC) undergoing minimally invasive gastrectomy.
Twenty-four patients treated surgically for early gastric cancer were enrolled in the PREP-GC. The exercise program comprised sessions of In-hospital Exercise (1 week), Home Exercise (1 week), and Fitness Improvement Exercise (8 weeks). Adherence and compliance to PREP-GC were evaluated. In addition, body composition, physical fitness, and QOL were assessed during the preoperative period, after the postoperative recovery (2 weeks after surgery), and upon completing the PREP-GC (10 weeks after surgery).
Of the 24 enrolled patients, 20 completed the study without any adverse events related to the PREP-GC. Adherence and compliance rates to the Fitness Improvement Exercise were 79.4% and 99.4%, respectively. Upon completing the PREP-GC, patients also exhibited restored cardiopulmonary function and muscular strength, with improved muscular endurance and flexibility (P < 0.05). Compared to those in the preoperative period, no differences were found in symptom scale scores measured using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and Quality of Life Questionnaire-Stomach Cancer-Specific Module (QLQ-STO22); however, higher scores for global health status and emotional functioning were observed after completing the PREP-GC (P < 0.05).
In gastric cancer patients undergoing minimally invasive gastrectomy, PREP-GC was found to be feasible and safe, with high adherence and compliance. Although randomized studies evaluating the benefits of exercise intervention during postoperative recovery are needed, surgeons should encourage patients to participate in systematic exercise intervention programs in the early postoperative period (Registered at the ClinicalTrials.gov NCT01751880).


Exercise; Gastric cancer; Recovery; Minimally invasive surgery
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