Postoperative Recovery in Patients Undergoing Gastrectomy: An Integrative Review

Abstract

Introduction: Gastrectomy is one of the main surgical procedures used in the treatment of gastric cancer and other upper gastrointestinal diseases, being associated with physiological, respiratory, and functional changes during the postoperative period. Despite advances in surgical techniques and enhanced recovery protocols, patients undergoing this procedure remain susceptible to pulmonary complications, muscle weakness, reduced mobility, functional impairment, and prolonged hospital stay. In this context, physical therapy plays a fundamental role in preventing complications, restoring respiratory function, and improving functional independence through an integrated multidisciplinary approach. Objective: To analyze postoperative recovery strategies in patients undergoing gastrectomy, emphasizing physical therapy interventions aimed at preventing respiratory complications, promoting functional recovery, encouraging early mobilization, and improving clinical outcomes and quality of life. Methods: This is a descriptive and analytical literature review conducted through an integrative review methodology. The databases consulted were the Virtual Health Library (VHL), Latin American and Caribbean Health Sciences Literature (LILACS), National Library of Medicine (PubMed), SciVerse Scopus (Scopus), and Scientific Electronic Library Online (SciELO). Eight studies published between 2008 and 2023 were included, selected according to their relevance to postoperative recovery after gastrectomy, addressing aspects related to respiratory physical therapy, early mobilization, Enhanced Recovery After Surgery (ERAS) protocols, pulmonary complications, functional recovery, and quality of life. Results: The analyzed studies demonstrated that patients undergoing gastrectomy have an increased risk of respiratory complications and functional limitations resulting from surgical trauma, immobility, and reduced physical capacity. Early mobilization, therapeutic exercises, respiratory physical therapy, muscle strengthening, and structured rehabilitation programs showed benefits in preventing pulmonary complications, improving respiratory function, restoring functional independence, and reducing hospital length of stay. The implementation of ERAS protocols was highlighted as an effective strategy to integrate surgical, nutritional, and physical therapy care, promoting faster and safer recovery. Conclusion: The findings of this review suggest that respiratory and motor physiotherapy, combined with early mobilization, therapeutic exercises, and optimized perioperative recovery strategies, may contribute to postoperative recovery in patients undergoing gastrectomy. However, the heterogeneity of the studies and interventions, as well as the presence of indirect or contextual evidence, limits the generalizability of the findings specifically to this population. Therefore, the observed benefits should be interpreted as potential contributions to functional and clinical recovery, and uniform effects on postoperative complications, length of hospital stay, functional independence, or quality of life cannot be established.