Digital therapy in post-operative rehabilitation of hepatocellular carcinoma: a case report_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YU Kaitao ¹ , JIA Jie ¹ ,  YIN Baobing ²

1. Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, P. R. China;
2. Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P. R. China;

Corresponding author：

YIN Baobing, Email: yinbaobing@126.com

Keywords：

liver cancer; oncology rehabilitation; digital therapy; functional disorder

DOI：

10.7507/1007-9424.202309052

Video：

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Objective To explore the rehabilitation treatment of postoperative dysfunction in hepatocellular carcinoma based on digital therapy and its clinical significance. Methods The postoperative rehabilitation clinic process of a patient was retrospectively analyzed according to the relevant clinical symptoms and dysfunctions, as well as the postoperative rehabilitation measures based on digital therapy and the patient’s prognosis. Results Combined with medical history, physical examination and rehabilitation assessment, the patient had pain, activity intolerance, insomnia, and symptom of anxiety and depression. The physical ability, pain, fatigue condition, symptom of anxiety and depression, and insomnia improved on 1 month after digital therapy-based exercise rehabilitation. Conclusion Exercise rehabilitation based on digital therapy can improve the adverse symptoms and dysfunctional condition of patients with certain advantages.

Citation： YU Kaitao, JIA Jie, YIN Baobing. Digital therapy in post-operative rehabilitation of hepatocellular carcinoma: a case report. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(11): 1294-1300. doi: 10.7507/1007-9424.202309052 Copy

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2.	Shi JF, Cao M, Wang Y, et al. Is it possible to halve the incidence of liver cancer in China by 2050? Int J Cancer, 2021, 148(5): 1051-1065.
3.	Shah BC, Smith LM, Ullrich F, et al. Discharge disposition after pancreatic resection for malignancy: analysis of national trends. HPB (Oxford), 2012, 14(3): 201-208.
4.	Paredes AZ, Beal EW, Bagante F, et al. Patterns of readmission among the elderly after hepatopancreatobiliary surgery. Am J Surg, 2019, 217(3): 413-416.
5.	Merath K, Bagante F, Chen Q, et al. The impact of discharge timing on readmission following hepatopancreatobiliary surgery: a nationwide readmission database analysis. J Gastrointest Surg, 2018, 22(9): 1538-1548.
6.	Xourafas D, Pawlik TM, Cloyd JM. Early morbidity and mortality after minimally invasive liver resection for hepatocellular carcinoma: a propensity-score matched comparison with open resection. J Gastrointest Surg, 2019, 23(7): 1435-1442.
7.	Coleman EA, Chugh A, Williams MV, et al. Understanding and execution of discharge instructions. Am J Med Qual, 2013, 28(5): 383-391.
8.	Chugh A, Williams MV, Grigsby J, et al. Better transitions: improving comprehension of discharge instructions. Front Health Serv Manage, 2009, 25(3): 11-32.
9.	Albrecht JS, Gruber-Baldini AL, Hirshon JM, et al. Hospital discharge instructions: comprehension and compliance among older adults. J Gen Intern Med, 2014, 29(11): 1491-1498.
10.	侯阿幸, 彭真, 张笑. 认知行为疗法联合家庭支持对居家肝癌患者心理状态、希望水平及社会支持的影响. 中国健康心理学杂志, 2022, 30(5): 684-688.
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14.	潘立茹, 张雯雯, 胡丙洋, 等. 肝癌晚期患者转化治疗前后心理痛苦及生活质量的调查. 南方医科大学学报, 2022, 42(10): 1539-1544.
15.	中国抗癌协会肝癌专业委员会转化治疗协作组. 肝癌转化治疗中国专家共识 (2021版). 中国实用外科杂志, 2021, 41(6): 618-632.
16.	Kvedar JC. Evidence for the effectiveness of digital health. NPJ Digit Med, 2020, 3: 34. doi: 10.1038/s41746-020-0231-9.
17.	Behrens G, Matthews CE, Moore SC, et al. The association between frequency of vigorous physical activity and hepatobiliary cancers in the NIH-AARP Diet and Health Study. Eur J Epidemiol, 2013, 28(1): 55-66.
18.	Crevenna R, Schmidinger M, Keilani M, et al. Aerobic exercise as additive palliative treatment for a patient with advanced hepatocellular cancer. Wien Med Wochenschr, 2003, 153(9-10): 237-240.
19.	Kim Y, Seo J, An SY, et al. Efficacy and safety of an mHealth App and wearable device in physical performance for patients with hepatocellular carcinoma: Development and Usability Study. JMIR Mhealth Uhealth, 2020, 8(3): e14435. doi: 10.2196/14435.
20.	Hallsworth K, McPherson S, Anstee QM, et al. Digital intervention with lifestyle coach support to target dietary and physical activity behaviors of adults with nonalcoholic fatty liver disease: systematic development process of VITALISE using intervention mapping. J Med Internet Res, 2021, 23(1): e20491. doi: 10.2196/20491.
21.	Chibnall JT, Videen SD, Duckro PN, et al. Psychosocial-spiritual correlates of death distress in patients with life-threatening medical conditions. Palliat Med, 2002, 16(4): 331-338.
22.	石春凤, 刘芳, 刘梅, 等. 原发性肝癌患者创伤后成长状况及其影响因素分析. 解放军护理杂志, 2015, 32(21): 28-31.
23.	刘恋蕊. 原发性肝癌术后患者创伤后成长现状及影响因素分析. 安徽医科大学, 2023.
24.	McLean LM, Jones JM. A review of distress and its management in couples facing end-of-life cancer. Psychooncology, 2007, 16(7): 603-616.
25.	The Lancet Digital Health None. Digital tools for mental health in a crisis. Lancet Digit Health, 2021, 3(4): e204. doi: 10.1016/S2589-7500(21)00045-5.
26.	Åsberg K, Bendtsen M. Perioperative digital behaviour change interventions for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation: a scoping review. Perioper Med (Lond), 2021, 10(1): 18. doi: 10.1186/s13741-021-00189-1.
27.	Dieli-Conwright CM, Courneya KS, Demark-Wahnefried W, et al. Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial. Breast Cancer Res, 2018, 20(1): 124. doi: 10.1186/s13058-018-1051-6.
28.	Schmidt ME, Wiskemann J, Armbrust P, et al. Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. Int J Cancer, 2015, 137(2): 471-480.
29.	Samuel SR, Maiya AG, Fernandes DJ, et al. Effectiveness of exercise-based rehabilitation on functional capacity and quality of life in head and neck cancer patients receiving chemo-radiotherapy. Support Care Cancer, 2019, 27(10): 3913-3920.
30.	Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc, 2019, 51(11): 2375-2390.
31.	Speck RM, Courneya KS, Mâsse LC, et al. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv, 2010, 4(2): 87-100.
32.	Jiang Y, Angeletti PC, Hoffman AJ. Investigating the physiological mechanisms between resistance training and pain relief in the cancer population: a literature review. J Cancer Ther, 2023, 14(2): 80-101.
33.	Zhang W, Hu B, Han J, et al. 174P a real-world study of PD-1 inhibitors combined with TKIs for HCC with major vascular invasion as the conversion therapy: a prospective, non-randomized, open-label cohort study. Ann Oncol, 2020, 31(Supplement 6): S1307.
34.	Zhang W, Hu B, Han J, et al. Surgery after conversion therapy with PD-1 inhibitors plus tyrosine kinase inhibitors are effective and safe for advanced hepatocellular carcinoma: a pilot study of ten patients. Front Oncol, 2021, 11: 747950. doi: 10.3389/fonc.2021.747950.
35.	Parrino L, Halasz P, Szucs A, et al. Sleep medicine: practice, challenges and new frontiers. Front Neurol, 2022, 13: 966659. doi: 10.3389/fneur.2022.966659.
36.	Cox NS, Dal Corso S, Hansen H, et al. Telerehabilitation for chronic respiratory disease. Cochrane Database Syst Rev, 2021, 1(1): CD013040.
37.	Sasso JP, Eves ND, Christensen JF, et al. A framework for prescription in exercise-oncology research. J Cachexia Sarcopenia Muscle, 2015, 6(2): 115-124.

1. 王瑞华, 胡明, 杨之雨, 等. 2000-2020年全球肝癌发病和死亡状况和未来流行趋势: GLOBOCAN数据分析. 中华肝脏病杂志, 2023, 31(3): 271-280.
2. Shi JF, Cao M, Wang Y, et al. Is it possible to halve the incidence of liver cancer in China by 2050? Int J Cancer, 2021, 148(5): 1051-1065.
3. Shah BC, Smith LM, Ullrich F, et al. Discharge disposition after pancreatic resection for malignancy: analysis of national trends. HPB (Oxford), 2012, 14(3): 201-208.
4. Paredes AZ, Beal EW, Bagante F, et al. Patterns of readmission among the elderly after hepatopancreatobiliary surgery. Am J Surg, 2019, 217(3): 413-416.
5. Merath K, Bagante F, Chen Q, et al. The impact of discharge timing on readmission following hepatopancreatobiliary surgery: a nationwide readmission database analysis. J Gastrointest Surg, 2018, 22(9): 1538-1548.
6. Xourafas D, Pawlik TM, Cloyd JM. Early morbidity and mortality after minimally invasive liver resection for hepatocellular carcinoma: a propensity-score matched comparison with open resection. J Gastrointest Surg, 2019, 23(7): 1435-1442.
7. Coleman EA, Chugh A, Williams MV, et al. Understanding and execution of discharge instructions. Am J Med Qual, 2013, 28(5): 383-391.
8. Chugh A, Williams MV, Grigsby J, et al. Better transitions: improving comprehension of discharge instructions. Front Health Serv Manage, 2009, 25(3): 11-32.
9. Albrecht JS, Gruber-Baldini AL, Hirshon JM, et al. Hospital discharge instructions: comprehension and compliance among older adults. J Gen Intern Med, 2014, 29(11): 1491-1498.
10. 侯阿幸, 彭真, 张笑. 认知行为疗法联合家庭支持对居家肝癌患者心理状态、希望水平及社会支持的影响. 中国健康心理学杂志, 2022, 30(5): 684-688.
11. Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet, 2018, 391(10127): 1301-1314.
12. Zhou J, Sun H, Wang Z, et al. Guidelines for the diagnosis and treatment of hepatocellular carcinoma (2019 Edition). Liver Cancer, 2020, 9(6): 682-720.
13. 刘连新, 孟凡征. 转化医学时代腹腔镜肝切除术治疗肝癌时机及关键问题. 中国实用外科杂志, 2022, 42(9): 975-978.
14. 潘立茹, 张雯雯, 胡丙洋, 等. 肝癌晚期患者转化治疗前后心理痛苦及生活质量的调查. 南方医科大学学报, 2022, 42(10): 1539-1544.
15. 中国抗癌协会肝癌专业委员会转化治疗协作组. 肝癌转化治疗中国专家共识 (2021版). 中国实用外科杂志, 2021, 41(6): 618-632.
16. Kvedar JC. Evidence for the effectiveness of digital health. NPJ Digit Med, 2020, 3: 34. doi: 10.1038/s41746-020-0231-9.
17. Behrens G, Matthews CE, Moore SC, et al. The association between frequency of vigorous physical activity and hepatobiliary cancers in the NIH-AARP Diet and Health Study. Eur J Epidemiol, 2013, 28(1): 55-66.
18. Crevenna R, Schmidinger M, Keilani M, et al. Aerobic exercise as additive palliative treatment for a patient with advanced hepatocellular cancer. Wien Med Wochenschr, 2003, 153(9-10): 237-240.
19. Kim Y, Seo J, An SY, et al. Efficacy and safety of an mHealth App and wearable device in physical performance for patients with hepatocellular carcinoma: Development and Usability Study. JMIR Mhealth Uhealth, 2020, 8(3): e14435. doi: 10.2196/14435.
20. Hallsworth K, McPherson S, Anstee QM, et al. Digital intervention with lifestyle coach support to target dietary and physical activity behaviors of adults with nonalcoholic fatty liver disease: systematic development process of VITALISE using intervention mapping. J Med Internet Res, 2021, 23(1): e20491. doi: 10.2196/20491.
21. Chibnall JT, Videen SD, Duckro PN, et al. Psychosocial-spiritual correlates of death distress in patients with life-threatening medical conditions. Palliat Med, 2002, 16(4): 331-338.
22. 石春凤, 刘芳, 刘梅, 等. 原发性肝癌患者创伤后成长状况及其影响因素分析. 解放军护理杂志, 2015, 32(21): 28-31.
23. 刘恋蕊. 原发性肝癌术后患者创伤后成长现状及影响因素分析. 安徽医科大学, 2023.
24. McLean LM, Jones JM. A review of distress and its management in couples facing end-of-life cancer. Psychooncology, 2007, 16(7): 603-616.
25. The Lancet Digital Health None. Digital tools for mental health in a crisis. Lancet Digit Health, 2021, 3(4): e204. doi: 10.1016/S2589-7500(21)00045-5.
26. Åsberg K, Bendtsen M. Perioperative digital behaviour change interventions for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation: a scoping review. Perioper Med (Lond), 2021, 10(1): 18. doi: 10.1186/s13741-021-00189-1.
27. Dieli-Conwright CM, Courneya KS, Demark-Wahnefried W, et al. Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial. Breast Cancer Res, 2018, 20(1): 124. doi: 10.1186/s13058-018-1051-6.
28. Schmidt ME, Wiskemann J, Armbrust P, et al. Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. Int J Cancer, 2015, 137(2): 471-480.
29. Samuel SR, Maiya AG, Fernandes DJ, et al. Effectiveness of exercise-based rehabilitation on functional capacity and quality of life in head and neck cancer patients receiving chemo-radiotherapy. Support Care Cancer, 2019, 27(10): 3913-3920.
30. Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc, 2019, 51(11): 2375-2390.
31. Speck RM, Courneya KS, Mâsse LC, et al. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv, 2010, 4(2): 87-100.
32. Jiang Y, Angeletti PC, Hoffman AJ. Investigating the physiological mechanisms between resistance training and pain relief in the cancer population: a literature review. J Cancer Ther, 2023, 14(2): 80-101.
33. Zhang W, Hu B, Han J, et al. 174P a real-world study of PD-1 inhibitors combined with TKIs for HCC with major vascular invasion as the conversion therapy: a prospective, non-randomized, open-label cohort study. Ann Oncol, 2020, 31(Supplement 6): S1307.
34. Zhang W, Hu B, Han J, et al. Surgery after conversion therapy with PD-1 inhibitors plus tyrosine kinase inhibitors are effective and safe for advanced hepatocellular carcinoma: a pilot study of ten patients. Front Oncol, 2021, 11: 747950. doi: 10.3389/fonc.2021.747950.
35. Parrino L, Halasz P, Szucs A, et al. Sleep medicine: practice, challenges and new frontiers. Front Neurol, 2022, 13: 966659. doi: 10.3389/fneur.2022.966659.
36. Cox NS, Dal Corso S, Hansen H, et al. Telerehabilitation for chronic respiratory disease. Cochrane Database Syst Rev, 2021, 1(1): CD013040.
37. Sasso JP, Eves ND, Christensen JF, et al. A framework for prescription in exercise-oncology research. J Cachexia Sarcopenia Muscle, 2015, 6(2): 115-124.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Digital therapy in post-operative rehabilitation of hepatocellular carcinoma: a case report

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