Preoperative walking speed and surgical aspects as predictors of early ambulation after abdominal cancer surgery: a prospective cohort study.

PURPOSE: To analyze the factors associated with ambulation on postoperative day 1 (POD1) in patients undergoing abdominal cancer surgery. As a secondary objective, the study aimed to investigate the impact of early ambulation on the occurrence of short-term postoperative outcomes. METHODS: This prospective cohort study included patients who underwent elective abdominal cancer surgery between April 2024 and July 2025. Preoperative handgrip strength (HGS) and walking speed, measured using the 10-Meter Walk Test (10MeWT), were assessed preoperatively. Logistic regression was used to identify factors associated with early ambulation. RESULTS: A total of 122 patients were included in the study, of whom 93 (76.2%) ambulated for the first time on POD1. Multivariate analysis showed that patients with a preoperative walking speed > 0.80 m/s (OR 4.74; 95% CI 1.41-15.96; p = 0.01), those who underwent gastrectomy (OR 8.20; 95% CI 1.36-49.32; p = 0.02), rectosigmoidectomy (OR 6.99; 95% CI 1.48-32.91; p = 0.01), and those with shorter operative times (OR 0.99; 95% CI 0.98-0.99; p = 0.02) were independently associated with early ambulation. The median length of hospital stay was significantly shorter among patients who ambulated on POD1 (p = 0.01). In-hospital mortality was also lower among those who ambulated on POD1 (p = 0.01). CONCLUSION: Patients who ambulated on POD1 exhibited a lower frequency of short-term postoperative complications. Preoperative walking speed, operative time, and type of surgical procedure were independent predictors of early ambulation in patients undergoing abdominal cancer surgery.