Postoperative early mobilisation protocol for endometrial cancer patients: a retrospective study.

BACKGROUND

Standardised early mobilisation within Enhanced Recovery After Surgery (ERAS) for endometrial cancer is lacking. This study developed and evaluated a protocol.

METHODS

This retrospective study analysed outcomes of a clinical quality improvement initiative conducted at a tertiary care centre (February 2021-May 2022). Phase 1: Protocol developed via evidence/expert consensus. Phase 2: Retrospective analysis of 90 patients who received care in two units during the study period. Patients admitted to unit A (n = 45) received a structured early mobilisation protocol implemented as part of routine clinical practice improvement, whilst patients admitted to unit B (n = 45) received standard care. Ward assignment was determined by bed availability at admission without researcher involvement in allocation. Primary outcomes: Pulmonary function, physical capacity (ambulation time/day 5 walking distance) and gastrointestinal recovery. Secondary: Complications, LOS, emotional status (Brief Profile of Mood States, BPOMS). Statistical analyses included effect sizes and 95% confidence intervals.

RESULTS

The intervention group was associated with significantly better first ambulation (6.8 ± 2.1 h vs. 18.5 ± 4.3 h, mean difference: 11.7 h, 95% CI: 10.3-13.1, p < 0.001), day 5 walking distance (385 ± 68 m vs. 142 ± 45 m, mean difference: 243 m, 95% CI: 220-266, p < 0.001), time to first flatus (28.5 ± 6.2 h vs. 48.3 ± 8.5 h, mean difference: 19.8 h, 95% CI: 16.9-22.7, p < 0.001), fewer pulmonary complications (8.9% vs. 24.4%, OR: 0.30, 95% CI: 0.09-0.96, p = 0.047), shorter LOS (4.2 ± 1.1 d vs. 6.8 ± 1.5 d, mean difference: 2.6 d, 95% CI: 2.0-3.2, p < 0.001) and improved BPOMS anxiety/depression scores.

CONCLUSIONS

This retrospective analysis suggests that the structured early mobilisation protocol, implemented as a clinical quality improvement initiative, was associated with improved recovery, reduced complications/LOS and better emotional wellbeing in endometrial cancer patients within ERAS.