Amy J. Litterini
© 2017 Elizabeth Race
Background and Purpose: Colorectal cancer (CRC) is the third most commonly diagnosed cancer, with an increasing prevalence in the United States. Surgical treatment is common and the American Society of Enhanced Recovery (ASER) established fast track protocols to reduce recovery time and length of stay in the hospital. Early mobilization is a key component of these protocols. The purpose of this case report is to describe the acute physical therapy (PT) for a patient who received a laparoscopic loop sigmoid colostomy. Case Description: The patient was a 73-year-old male admitted to the hospital to receive surgery for a permanent colostomy due to his diagnosis of stage II adenocarcinoma of the rectum. PT evaluation and treatment began post-operative day (POD) one. He presented below his baseline level of function, as he was previously independent in mobility and activities of daily living (ADLs). At the time of evaluation, he had limitations in bed mobility, transfers, and tolerance to activity. Treatment focused on a task oriented approach addressing limitations in functional mobility. Outcomes: The patient was assessed on his required level of assistance at initial evaluation and discharge. He demonstrated improvements in all functional mobility; bed mobility (moderate assistance to independence), transfers (minimal assist to independence), ambulation (contact guard assist for 150 feet to supervision for 350 feet), and stair negotiation (unable to perform to close guarding with ascending/descending nine stairs). Discussion: This patient had the benefit of following the multidisciplinary ASER protocol and received early mobilization guided by a skilled physical therapist. He was discharged to inpatient rehab after eight days in the hospital. Further research should look at pre-habilitation to determine how that affects outcomes.
Race, Elizabeth, "Acute Care Physical Therapy Status Post Laparoscopic Loop Sigmoid Colostomy For A Patient With Colorectal Cancer: A Case Report" (2017). Case Report Papers. 86.