"The groundwork of all happiness is health." - Leigh Hunt

The secret weapon of surgery that increasingly doctors are recommending

November 9, 2023 – Need more motivation to hit your each day step count? You could avoid painful and even life-threatening complications after surgery.

There is increasing evidence that physical activity can reduce the chance of complications after surgery. Thanks to recent fitness tracker data, researchers on the Medical College of Wisconsin have nailed down a number: People who walk at the least 7,500 steps per day have a much lower risk of developing such complications than those that walk fewer.

This applies even to patients with a better body mass index (BMI) or health problems, in addition to those undergoing more complex surgeries, the researchers said presented their findings, which haven’t yet been published, on the recent clinical meeting of the American College of Surgeons in Boston.

“The remarkable thing about this study is that we are finally beginning to quantify exactly how much optimization we can make in the area of ​​exercise,” said Thomas Varghese, MD, chief of general thoracic surgery on the University of Utah in Salt Lake City . (Varghese was not involved within the study.)

Researchers analyzed fitness tracker data from nearly 500 people (average age 57) within the months or years before their surgeries. Those who took at the least 7,500 steps per day were, on average, 51% less prone to experience a complication, resembling an infection or a slow-healing wound, inside three months of the procedure.

“There are likely several factors that explain our results,” said lead study writer Anai Kothari, MD, professor of surgical oncology on the Medical College of Wisconsin. “We speculate that improved physical fitness may alter the stress response to surgery and lead to better outcomes.”

Many of the surgeries were performed “low risk,” with the patient either spending only one night within the hospital recovering or going home the identical day, Kothari noted. The commonest procedures included hysterectomy, thyroidectomy, breast reconstruction, and orthopedic surgery. Overall, 13% of patients had postoperative complications, which is consistent with the statistics of previous studies.

The power of “Prehab”

The study is predicated on a growing scope of research Linking the fitness of a patient's heart and lungs to surgical outcomes. Researchers have concluded that higher levels of fitness may make people higher in a position to tolerate complications and speed recovery. It may additionally help protect a patient from inflammation as a result of anxiety before surgery and reduced oxygen intake from anesthesia. Fitness can be related to higher mood and emotional well-being It has been shown to aid healing.

Surgical complications could cause pain and suffering, increased medical costs, and even death in lower than 1% of cases. With this in mind, doctors are actually more prone to recommend physical activity and exercise programs to scale back the chance of surgery.

Several randomized controlled trials have shown that incorporating exercise into “prehab” programs significantly reduces complications after surgery. Prehab, short for “prehabilitation,” includes fitness activities that get people into higher physical shape before surgery. A June meta-analysis found that high-intensity interval training before major surgery reduced the likelihood of complications by 56%. And a Meta-analysis 2022 found that patients who received an exercise plan during screening had 5% fewer complications and were 28% less prone to visit the emergency room 30 days after colorectal cancer surgery. (A meta-analysis uses data from multiple studies to succeed in its conclusion.)

Ideally, people should maintain a high level of baseline fitness well before undergoing surgery. But just two to a few weeks later, starting a tailored fitness plan could make a difference, said Varghese, who helped create the ACS Strong for surgery Prehab program

“The goal of surgery is to perform a direct action that results in better function,” Varghese said. “When we optimize health before surgery, you are essentially preparing your body for the best results.”