Effect of Early Postoperative Mobilization on Functional Recovery, Hospital Length of Stay, and Postoperative Complications After Immediate Internal Pudendal Artery Perforator Flap Reconstruction for Irradiated Abdominoperineal Resection Defects: A Prospective, Randomized Controlled Trial
Background Patients undergoing perineal defect reconstruction with the internal pudendal artery perforator (IPAP) flap traditionally face 5 days of postoperative bed rest (BR) to minimize surgical risks. However, prolonged BR can exacerbate postoperative physiologic changes such as increased fatigue...
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| Veröffentlicht in: | Annals of surgical oncology 2025-02, Vol.32 (2), p.993-1004 |
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| creator | Lima de Araujo, Caio Augusto de Freitas Busnardo, Fabio Thome Grillo, Victor Augusto Chirnev Felício, Carlos Henrique Antônia de Almeida, Luciana Alexandra Sparapan Marques, Carlos Frederico Nahas, Caio Sérgio Imperialle, Antonio Rocco de Castro Cotti, Guilherme Cutait Gemperli, Rolf Ribeiro, Ulysses |
| description | Background
Patients undergoing perineal defect reconstruction with the internal pudendal artery perforator (IPAP) flap traditionally face 5 days of postoperative bed rest (BR) to minimize surgical risks. However, prolonged BR can exacerbate postoperative physiologic changes such as increased fatigue, reduced body mass, and declining lung function, while also leading to complications such as pneumonia, delirium, deep vein thrombosis, and pressure injuries. This study assessed the effectiveness, feasibility, and safety of an adapted early mobilization (EM) program for these patients.
Methods
This prospective, randomized, controlled clinical study involved 51 patients assigned to adapted EM (
n
= 25) or BR (
n
= 26). Whereas EM included core exercises, orthostasis training, gait training, muscle strengthening, and aerobic exercises after surgery, BR followed standard bed rest protocols. The primary outcome was independent ambulation for 3 m on postoperative day 5. The secondary outcomes included 6-min walk test (6MWT) distances on days 5 and 30, hospital length of stay, healing time, postoperative complications, fatigue prevalence, and quality of life.
Results
On day 5, EM improved ambulation significantly compared with BR (68.0% vs 38.5%;
P
= 0.035) and achieved greater 6MWT distances on days 5 (108.78 vs 47.73 m;
P
= 0.041) and 30 (243.8 vs 166.29 m;
P
= 0.018). The EM patients were discharged earlier (66.7% by day 10 vs 33.3% of the BR patients;
P
= 0.043), with comparable healing times (
P
= 0.06) and postoperative complication rates (68% vs 80.8%;
P
= 0.296). Fatigue prevalence and quality of life did not differ significantly between the two groups.
Conclusion
Early mobilization after IPAP flap reconstruction is safe and feasible, promoting early ambulation and recovery and facilitating earlier discharge without increasing complications. |
| doi_str_mv | 10.1245/s10434-024-16497-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3130207468</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3130207468</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-8471cc5cb3eb8c909952918b73083a00180f69f963aafc4f2d3b75bfba8f78f83</originalsourceid><addsrcrecordid>eNp9Uk1v1DAQDQhES-EPcEBGXDg0YMdxPritll260iJWpZwjx7GLK8dObWfV7a9nki0g9YAUKeOZN2-exy9J3hD8kWQ5-xQIzmme4ixPSZHXZXr3NDklDFJ5UZFnEOOiSuusYCfJyxBuMCYlxexFckJrxsoyy06fvFspJUVETqEV9-aAdi5EN0jPo95L9M212uh7ODiL4FuPVkwxN-hSCreX_nCOLlwYdITUVtrr-Gvi-hE5FLjtHvEtXT8YLWa-gBYqSo82fS87zaNEGwvniXs3dtJ2ECw8ZECU9MoBhfNobfgwz7Yh-nEWg6CGNt7zmaVDi7ZzvbbTVG3lLDXII_KLnG4bPqMF2nmQPaX38hxdglTouYfupbPRO2MgvPKam1fJc8VNkK8f_mfJz_XqanmRbr9_3SwX21RkrIhplZdECCZaKttK1LiuWVaTqoWNV5TD6iusilrVBeVciVxlHW1L1qqWV6qsVEXPkg9H3sG721GG2PQ6CGkMt9KNoaGE4gyX8LQAff8IeuPGaXETigGuKMsaUNkRJeCmwUvVDF733B8agpvJQM3RQA0YqJkN1NxB09sH6rGFZ_nb8scxAKBHQICSvZb-3-z_0P4GoJXYog</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3151306779</pqid></control><display><type>article</type><title>Effect of Early Postoperative Mobilization on Functional Recovery, Hospital Length of Stay, and Postoperative Complications After Immediate Internal Pudendal Artery Perforator Flap Reconstruction for Irradiated Abdominoperineal Resection Defects: A Prospective, Randomized Controlled Trial</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Lima de Araujo, Caio Augusto ; de Freitas Busnardo, Fabio ; Thome Grillo, Victor Augusto ; Chirnev Felício, Carlos Henrique ; Antônia de Almeida, Luciana Alexandra ; Sparapan Marques, Carlos Frederico ; Nahas, Caio Sérgio ; Imperialle, Antonio Rocco ; de Castro Cotti, Guilherme Cutait ; Gemperli, Rolf ; Ribeiro, Ulysses</creator><creatorcontrib>Lima de Araujo, Caio Augusto ; de Freitas Busnardo, Fabio ; Thome Grillo, Victor Augusto ; Chirnev Felício, Carlos Henrique ; Antônia de Almeida, Luciana Alexandra ; Sparapan Marques, Carlos Frederico ; Nahas, Caio Sérgio ; Imperialle, Antonio Rocco ; de Castro Cotti, Guilherme Cutait ; Gemperli, Rolf ; Ribeiro, Ulysses</creatorcontrib><description>Background
Patients undergoing perineal defect reconstruction with the internal pudendal artery perforator (IPAP) flap traditionally face 5 days of postoperative bed rest (BR) to minimize surgical risks. However, prolonged BR can exacerbate postoperative physiologic changes such as increased fatigue, reduced body mass, and declining lung function, while also leading to complications such as pneumonia, delirium, deep vein thrombosis, and pressure injuries. This study assessed the effectiveness, feasibility, and safety of an adapted early mobilization (EM) program for these patients.
Methods
This prospective, randomized, controlled clinical study involved 51 patients assigned to adapted EM (
n
= 25) or BR (
n
= 26). Whereas EM included core exercises, orthostasis training, gait training, muscle strengthening, and aerobic exercises after surgery, BR followed standard bed rest protocols. The primary outcome was independent ambulation for 3 m on postoperative day 5. The secondary outcomes included 6-min walk test (6MWT) distances on days 5 and 30, hospital length of stay, healing time, postoperative complications, fatigue prevalence, and quality of life.
Results
On day 5, EM improved ambulation significantly compared with BR (68.0% vs 38.5%;
P
= 0.035) and achieved greater 6MWT distances on days 5 (108.78 vs 47.73 m;
P
= 0.041) and 30 (243.8 vs 166.29 m;
P
= 0.018). The EM patients were discharged earlier (66.7% by day 10 vs 33.3% of the BR patients;
P
= 0.043), with comparable healing times (
P
= 0.06) and postoperative complication rates (68% vs 80.8%;
P
= 0.296). Fatigue prevalence and quality of life did not differ significantly between the two groups.
Conclusion
Early mobilization after IPAP flap reconstruction is safe and feasible, promoting early ambulation and recovery and facilitating earlier discharge without increasing complications.</description><identifier>ISSN: 1068-9265</identifier><identifier>ISSN: 1534-4681</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-024-16497-x</identifier><identifier>PMID: 39557722</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Aged ; Body mass ; Complications ; Early Ambulation ; Exercise ; Fatigue ; Feasibility studies ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Length of Stay ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Patients ; Perforator Flap ; Perineum ; Perineum - surgery ; Plastic Surgery Procedures - methods ; Postoperative ; Postoperative Complications - etiology ; Proctectomy - adverse effects ; Prognosis ; Prospective Studies ; Quality of Life ; Reconstructive Oncology ; Reconstructive surgery ; Recovery of Function ; Rectal Neoplasms - surgery ; Respiratory function ; Surgery ; Surgical Oncology ; Thrombosis</subject><ispartof>Annals of surgical oncology, 2025-02, Vol.32 (2), p.993-1004</ispartof><rights>Society of Surgical Oncology 2024 corrected publication 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. Society of Surgical Oncology.</rights><rights>Copyright Springer Nature B.V. Feb 2025</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-8471cc5cb3eb8c909952918b73083a00180f69f963aafc4f2d3b75bfba8f78f83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-024-16497-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-024-16497-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39557722$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lima de Araujo, Caio Augusto</creatorcontrib><creatorcontrib>de Freitas Busnardo, Fabio</creatorcontrib><creatorcontrib>Thome Grillo, Victor Augusto</creatorcontrib><creatorcontrib>Chirnev Felício, Carlos Henrique</creatorcontrib><creatorcontrib>Antônia de Almeida, Luciana Alexandra</creatorcontrib><creatorcontrib>Sparapan Marques, Carlos Frederico</creatorcontrib><creatorcontrib>Nahas, Caio Sérgio</creatorcontrib><creatorcontrib>Imperialle, Antonio Rocco</creatorcontrib><creatorcontrib>de Castro Cotti, Guilherme Cutait</creatorcontrib><creatorcontrib>Gemperli, Rolf</creatorcontrib><creatorcontrib>Ribeiro, Ulysses</creatorcontrib><title>Effect of Early Postoperative Mobilization on Functional Recovery, Hospital Length of Stay, and Postoperative Complications After Immediate Internal Pudendal Artery Perforator Flap Reconstruction for Irradiated Abdominoperineal Resection Defects: A Prospective, Randomized Controlled Trial</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Patients undergoing perineal defect reconstruction with the internal pudendal artery perforator (IPAP) flap traditionally face 5 days of postoperative bed rest (BR) to minimize surgical risks. However, prolonged BR can exacerbate postoperative physiologic changes such as increased fatigue, reduced body mass, and declining lung function, while also leading to complications such as pneumonia, delirium, deep vein thrombosis, and pressure injuries. This study assessed the effectiveness, feasibility, and safety of an adapted early mobilization (EM) program for these patients.
Methods
This prospective, randomized, controlled clinical study involved 51 patients assigned to adapted EM (
n
= 25) or BR (
n
= 26). Whereas EM included core exercises, orthostasis training, gait training, muscle strengthening, and aerobic exercises after surgery, BR followed standard bed rest protocols. The primary outcome was independent ambulation for 3 m on postoperative day 5. The secondary outcomes included 6-min walk test (6MWT) distances on days 5 and 30, hospital length of stay, healing time, postoperative complications, fatigue prevalence, and quality of life.
Results
On day 5, EM improved ambulation significantly compared with BR (68.0% vs 38.5%;
P
= 0.035) and achieved greater 6MWT distances on days 5 (108.78 vs 47.73 m;
P
= 0.041) and 30 (243.8 vs 166.29 m;
P
= 0.018). The EM patients were discharged earlier (66.7% by day 10 vs 33.3% of the BR patients;
P
= 0.043), with comparable healing times (
P
= 0.06) and postoperative complication rates (68% vs 80.8%;
P
= 0.296). Fatigue prevalence and quality of life did not differ significantly between the two groups.
Conclusion
Early mobilization after IPAP flap reconstruction is safe and feasible, promoting early ambulation and recovery and facilitating earlier discharge without increasing complications.</description><subject>Aged</subject><subject>Body mass</subject><subject>Complications</subject><subject>Early Ambulation</subject><subject>Exercise</subject><subject>Fatigue</subject><subject>Feasibility studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Immobilization</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Patients</subject><subject>Perforator Flap</subject><subject>Perineum</subject><subject>Perineum - surgery</subject><subject>Plastic Surgery Procedures - methods</subject><subject>Postoperative</subject><subject>Postoperative Complications - etiology</subject><subject>Proctectomy - adverse effects</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Reconstructive Oncology</subject><subject>Reconstructive surgery</subject><subject>Recovery of Function</subject><subject>Rectal Neoplasms - surgery</subject><subject>Respiratory function</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Thrombosis</subject><issn>1068-9265</issn><issn>1534-4681</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Uk1v1DAQDQhES-EPcEBGXDg0YMdxPritll260iJWpZwjx7GLK8dObWfV7a9nki0g9YAUKeOZN2-exy9J3hD8kWQ5-xQIzmme4ixPSZHXZXr3NDklDFJ5UZFnEOOiSuusYCfJyxBuMCYlxexFckJrxsoyy06fvFspJUVETqEV9-aAdi5EN0jPo95L9M212uh7ODiL4FuPVkwxN-hSCreX_nCOLlwYdITUVtrr-Gvi-hE5FLjtHvEtXT8YLWa-gBYqSo82fS87zaNEGwvniXs3dtJ2ECw8ZECU9MoBhfNobfgwz7Yh-nEWg6CGNt7zmaVDi7ZzvbbTVG3lLDXII_KLnG4bPqMF2nmQPaX38hxdglTouYfupbPRO2MgvPKam1fJc8VNkK8f_mfJz_XqanmRbr9_3SwX21RkrIhplZdECCZaKttK1LiuWVaTqoWNV5TD6iusilrVBeVciVxlHW1L1qqWV6qsVEXPkg9H3sG721GG2PQ6CGkMt9KNoaGE4gyX8LQAff8IeuPGaXETigGuKMsaUNkRJeCmwUvVDF733B8agpvJQM3RQA0YqJkN1NxB09sH6rGFZ_nb8scxAKBHQICSvZb-3-z_0P4GoJXYog</recordid><startdate>20250201</startdate><enddate>20250201</enddate><creator>Lima de Araujo, Caio Augusto</creator><creator>de Freitas Busnardo, Fabio</creator><creator>Thome Grillo, Victor Augusto</creator><creator>Chirnev Felício, Carlos Henrique</creator><creator>Antônia de Almeida, Luciana Alexandra</creator><creator>Sparapan Marques, Carlos Frederico</creator><creator>Nahas, Caio Sérgio</creator><creator>Imperialle, Antonio Rocco</creator><creator>de Castro Cotti, Guilherme Cutait</creator><creator>Gemperli, Rolf</creator><creator>Ribeiro, Ulysses</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20250201</creationdate><title>Effect of Early Postoperative Mobilization on Functional Recovery, Hospital Length of Stay, and Postoperative Complications After Immediate Internal Pudendal Artery Perforator Flap Reconstruction for Irradiated Abdominoperineal Resection Defects: A Prospective, Randomized Controlled Trial</title><author>Lima de Araujo, Caio Augusto ; de Freitas Busnardo, Fabio ; Thome Grillo, Victor Augusto ; Chirnev Felício, Carlos Henrique ; Antônia de Almeida, Luciana Alexandra ; Sparapan Marques, Carlos Frederico ; Nahas, Caio Sérgio ; Imperialle, Antonio Rocco ; de Castro Cotti, Guilherme Cutait ; Gemperli, Rolf ; Ribeiro, Ulysses</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-8471cc5cb3eb8c909952918b73083a00180f69f963aafc4f2d3b75bfba8f78f83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Aged</topic><topic>Body mass</topic><topic>Complications</topic><topic>Early Ambulation</topic><topic>Exercise</topic><topic>Fatigue</topic><topic>Feasibility studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Immobilization</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Patients</topic><topic>Perforator Flap</topic><topic>Perineum</topic><topic>Perineum - surgery</topic><topic>Plastic Surgery Procedures - methods</topic><topic>Postoperative</topic><topic>Postoperative Complications - etiology</topic><topic>Proctectomy - adverse effects</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Reconstructive Oncology</topic><topic>Reconstructive surgery</topic><topic>Recovery of Function</topic><topic>Rectal Neoplasms - surgery</topic><topic>Respiratory function</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Thrombosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lima de Araujo, Caio Augusto</creatorcontrib><creatorcontrib>de Freitas Busnardo, Fabio</creatorcontrib><creatorcontrib>Thome Grillo, Victor Augusto</creatorcontrib><creatorcontrib>Chirnev Felício, Carlos Henrique</creatorcontrib><creatorcontrib>Antônia de Almeida, Luciana Alexandra</creatorcontrib><creatorcontrib>Sparapan Marques, Carlos Frederico</creatorcontrib><creatorcontrib>Nahas, Caio Sérgio</creatorcontrib><creatorcontrib>Imperialle, Antonio Rocco</creatorcontrib><creatorcontrib>de Castro Cotti, Guilherme Cutait</creatorcontrib><creatorcontrib>Gemperli, Rolf</creatorcontrib><creatorcontrib>Ribeiro, Ulysses</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lima de Araujo, Caio Augusto</au><au>de Freitas Busnardo, Fabio</au><au>Thome Grillo, Victor Augusto</au><au>Chirnev Felício, Carlos Henrique</au><au>Antônia de Almeida, Luciana Alexandra</au><au>Sparapan Marques, Carlos Frederico</au><au>Nahas, Caio Sérgio</au><au>Imperialle, Antonio Rocco</au><au>de Castro Cotti, Guilherme Cutait</au><au>Gemperli, Rolf</au><au>Ribeiro, Ulysses</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Early Postoperative Mobilization on Functional Recovery, Hospital Length of Stay, and Postoperative Complications After Immediate Internal Pudendal Artery Perforator Flap Reconstruction for Irradiated Abdominoperineal Resection Defects: A Prospective, Randomized Controlled Trial</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2025-02-01</date><risdate>2025</risdate><volume>32</volume><issue>2</issue><spage>993</spage><epage>1004</epage><pages>993-1004</pages><issn>1068-9265</issn><issn>1534-4681</issn><eissn>1534-4681</eissn><abstract>Background
Patients undergoing perineal defect reconstruction with the internal pudendal artery perforator (IPAP) flap traditionally face 5 days of postoperative bed rest (BR) to minimize surgical risks. However, prolonged BR can exacerbate postoperative physiologic changes such as increased fatigue, reduced body mass, and declining lung function, while also leading to complications such as pneumonia, delirium, deep vein thrombosis, and pressure injuries. This study assessed the effectiveness, feasibility, and safety of an adapted early mobilization (EM) program for these patients.
Methods
This prospective, randomized, controlled clinical study involved 51 patients assigned to adapted EM (
n
= 25) or BR (
n
= 26). Whereas EM included core exercises, orthostasis training, gait training, muscle strengthening, and aerobic exercises after surgery, BR followed standard bed rest protocols. The primary outcome was independent ambulation for 3 m on postoperative day 5. The secondary outcomes included 6-min walk test (6MWT) distances on days 5 and 30, hospital length of stay, healing time, postoperative complications, fatigue prevalence, and quality of life.
Results
On day 5, EM improved ambulation significantly compared with BR (68.0% vs 38.5%;
P
= 0.035) and achieved greater 6MWT distances on days 5 (108.78 vs 47.73 m;
P
= 0.041) and 30 (243.8 vs 166.29 m;
P
= 0.018). The EM patients were discharged earlier (66.7% by day 10 vs 33.3% of the BR patients;
P
= 0.043), with comparable healing times (
P
= 0.06) and postoperative complication rates (68% vs 80.8%;
P
= 0.296). Fatigue prevalence and quality of life did not differ significantly between the two groups.
Conclusion
Early mobilization after IPAP flap reconstruction is safe and feasible, promoting early ambulation and recovery and facilitating earlier discharge without increasing complications.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>39557722</pmid><doi>10.1245/s10434-024-16497-x</doi><tpages>12</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2025-02, Vol.32 (2), p.993-1004 |
| issn | 1068-9265 1534-4681 1534-4681 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Body mass Complications Early Ambulation Exercise Fatigue Feasibility studies Female Follow-Up Studies Humans Immobilization Length of Stay Male Medicine Medicine & Public Health Middle Aged Oncology Patients Perforator Flap Perineum Perineum - surgery Plastic Surgery Procedures - methods Postoperative Postoperative Complications - etiology Proctectomy - adverse effects Prognosis Prospective Studies Quality of Life Reconstructive Oncology Reconstructive surgery Recovery of Function Rectal Neoplasms - surgery Respiratory function Surgery Surgical Oncology Thrombosis |
| title | Effect of Early Postoperative Mobilization on Functional Recovery, Hospital Length of Stay, and Postoperative Complications After Immediate Internal Pudendal Artery Perforator Flap Reconstruction for Irradiated Abdominoperineal Resection Defects: A Prospective, Randomized Controlled Trial |
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