CLINICAL EFFECTIVENESS OF A STRUCTURED POSTOPERATIVE REHABILITATION ALGORITHM IN OBESE PATIENTS AFTER LAPAROSCOPIC SURGERY
Keywords:
obesity, laparoscopic surgery, postoperative rehabilitation, breathing exercises, early rehabilitationAbstract
Introduction. Obesity is a major risk factor for adverse postoperative outcomes in patients undergoing laparoscopic surgery. Despite the advantages of minimally invasive techniques, obese patients remain at increased risk of respiratory, functional, and thromboembolic complications. Aim. To evaluate the effectiveness of a structured postoperative medical rehabilitation algorithm in obese patients after laparoscopic surgery compared with standard postoperative care. Materials and Methods. A prospective comparative study included 136 obese patients who underwent elective laparoscopic procedures. The main group (n = 72) received a comprehensive rehabilitation program, while the control group (n = 64) received standard postoperative care. Clinical and functional parameters, physical performance, C-reactive protein levels, and postoperative complications were assessed.
Results. The rehabilitation algorithm resulted in faster recovery of respiratory function and physical activity, improved exercise tolerance, and earlier reduction of inflammatory markers. The rate of postoperative complications was significantly lower in the main group compared with the control group.
Conclusion. The proposed medical rehabilitation algorithm for obese patients after laparoscopic surgery is clinically effective and safe, promoting functional recovery and reducing postoperative complications, which supports its implementation in routine surgical practice.
References
Hoshino, N., Hida, K., Fujita, Y., Ohira, M., Ozawa, H., et al. (2023). Impact of laparoscopic surgery on short-term and long-term outcomes in elderly obese patients with colon cancer. Annals of Gastroenterological Surgery, 7, 757–764.
Matsumi, Y., Kikuchi, S., Shoji, R., Teraishi, F., & Fujiwara, T. (2024). A case of laparoscopic left hemicolectomy for transverse colon cancer with severe obesity performed safely by multidisciplinary perioperative management. Cureus, 16.
Vargas, G. M., Sieloff, E., Parmar, A. D., Tamirisa, N., Mehta, H., & Riall, T. (2016). Laparoscopy decreases complications for obese patients undergoing elective rectal surgery. Surgical Endoscopy, 30, 1826–1832.
Yu, Y. L., Hsu, Y., Liao, C. K., Lin, Y. C., You, J., & Tsai, W. (2023). Advantage of laparoscopic surgery in patients with generalized obesity operated for colorectal malignancy. Frontiers in Surgery, 9.
Danwang, C., Agbor, V., & Bigna, J. (2020). Obesity and postoperative outcomes of patients with laparoscopic adrenalectomy: A systematic review and meta-analysis. BMC Surgery, 20.
Mouawad, C., Ramadan, B., Dahboul, H., Aoun, R., Kassar, S., & Kassouf, E. (2022). Obesity: A risk factor for postoperative complications in laparoscopic surgery for colorectal cancer. Journal of Minimal Access Surgery.
Bizzoca, C., Zupo, R., Aquilino, F., Castellana, F., Fiore, F., & Vincenti, L. (2021). Video-laparoscopic versus open surgery in obese patients with colorectal cancer: A propensity score matching study. Cancers, 13.
Španring, T., Turk, Š., Plahuta, I., Magdalenić, T., Laufer, K., & Ivanecz, A. (2023). The impact of obesity on short-term outcomes after laparoscopic liver resection: A single-institution experience. Videosurgery and Other Miniinvasive Techniques, 19, 83–90.
Tani, T., Imai, S., & Fushimi, K. (2022). Longer daily duration of supervised rehabilitation after laparoscopic surgery for colorectal cancer improves activities of daily living. Journal of Rehabilitation Medicine, 54.
Sahoo, M., Gowda, M., & Kumar, A. T. (2014). Early rehabilitation after surgery program versus conventional care during perioperative period in patients undergoing laparoscopic assisted total gastrectomy. Journal of Minimal Access Surgery, 10, 132–138.
Eldemrdash, A., Gamaleldeen, N. M., Ahmed, M., & Ahmed, S. (2017). A comparative study between protective lung ventilation versus conventional ventilation in obese patients undergoing abdominal laparoscopic surgery. Journal of Anesthesia and Clinical Research, 8, 1–8.
Meshram, T. M., Dang, D., Sharma, A., Kumari, K., Rathod, D. K., & Bhatia, P. (2025). Effects of intraoperative recruitment maneuver in patients with obesity undergoing laparoscopic surgery: A narrative review. Journal of Anaesthesiology Clinical Pharmacology.
