Preoperative walking speed and surgical aspects as predictors of early ambulation after abdominal cancer surgery: a prospective cohort study.

PURPOSE: To analyze the factors associated with ambulation on postoperative day 1 (POD1) in patients undergoing abdominal cancer surgery. As a secondary objective, the study aimed to investigate the impact of early ambulation on the occurrence of short-term postoperative outcomes.

METHODS

This prospective cohort study included patients who underwent elective abdominal cancer surgery between April 2024 and July 2025. Preoperative handgrip strength (HGS) and walking speed, measured using the 10-Meter Walk Test (10MeWT), were assessed preoperatively. Logistic regression was used to identify factors associated with early ambulation.

RESULTS

A total of 122 patients were included in the study, of whom 93 (76.2%) ambulated for the first time on POD1. Multivariate analysis showed that patients with a preoperative walking speed > 0.80 m/s (OR 4.74; 95% CI 1.41-15.96; p = 0.01), those who underwent gastrectomy (OR 8.20; 95% CI 1.36-49.32; p = 0.02), rectosigmoidectomy (OR 6.99; 95% CI 1.48-32.91; p = 0.01), and those with shorter operative times (OR 0.99; 95% CI 0.98-0.99; p = 0.02) were independently associated with early ambulation. The median length of hospital stay was significantly shorter among patients who ambulated on POD1 (p = 0.01). In-hospital mortality was also lower among those who ambulated on POD1 (p = 0.01).

CONCLUSION

Patients who ambulated on POD1 exhibited a lower frequency of short-term postoperative complications. Preoperative walking speed, operative time, and type of surgical procedure were independent predictors of early ambulation in patients undergoing abdominal cancer surgery.