Early mobilization after esophageal cancer surgery: a retrospective cohort study

Nannet Schuring, Sven Jacobus Gertruda Geelen, Mark I. van Berge Henegouwen, Sander C.M. Steenhuizen, Marike van der Schaf, Marike van der Leeden, Suzanne S. Gisbertz

Research output: Contribution to journalArticleAcademicpeer-review


A key component of the Enhanced Recovery After Surgery pathway for esophagectomy is early mobilization. Evidence on a specific protocol of early and structured mobilization is scarce, which explains variation in clinical practice. This study aims to describe and evaluate the early mobilization practice after esophagectomy for cancer in a tertiary referral center in the Netherlands. This retrospective cohort study included data from a prospectively maintained database of patients who underwent an esophagectomy between 1 January 2015 and 1 January 2020. Early mobilization entailed increase in activity with the first target of ambulating 100 meters. Primary outcomes were the number of postoperative days (PODs) until achieving this target and reasons for not achieving this target. Secondary outcomes were the relationship between preoperative factors (e.g. sex, BMI) and achieving the target on POD1, and the relationship between achieving the target on POD1 and postoperative outcomes (i.e. length of stay, readmissions). In total, 384 patients were included. The median POD of achieving the target was 2 (IQR 1–3), with 173 (45.1%) patients achieving this on POD1. Main reason for not achieving this target was due to hemodynamic instability (22.7%). Male sex was associated with achieving the target on POD1 (OR = 1.997, 95%CI 1.172–3.403, P = 0.011); achieving this target was not associated with postoperative outcomes. Ambulation up to 100 m on POD1 is achievable in patients after esophagectomy, with higher odds for men to achieve this target. ERAS pathways for post esophagectomy care are encouraged to incorporate 100 m ambulation on POD1 in their guideline as the first postoperative target.
Original languageEnglish
JournalDiseases of the Esophagus
Issue number6
Publication statusPublished - 6 Dec 2022
Externally publishedYes


  • early ambulation/methods
  • esophageal neoplasms/surgery
  • esophagectomy/adverse effects
  • humans
  • male
  • postoperative complications/epidemiology
  • retrospective studies


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