Chang XM, Cai BH, Zheng HB. Integration of the PIPOST model with early enteral nutrition to enhance postoperative rehabilitation in colorectal cancer patients. World J Gastrointest Oncol 2026; 18(4): 115485 [DOI: 10.4251/wjgo.v18.i4.115485]
Corresponding Author of This Article
Hai-Bin Zheng, Associate Chief Physician, Department of General Surgery, Putuo Renji Hospital, No. 90 Gongxia Road, Putuo District, Zhoushan 316100, Zhejiang Province, China. 13706809729@163.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Randomized Controlled Trial
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Apr 15, 2026 (publication date) through Apr 11, 2026
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Oncology
ISSN
1948-5204
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Chang XM, Cai BH, Zheng HB. Integration of the PIPOST model with early enteral nutrition to enhance postoperative rehabilitation in colorectal cancer patients. World J Gastrointest Oncol 2026; 18(4): 115485 [DOI: 10.4251/wjgo.v18.i4.115485]
Bing-Hua Cai, Department of General Surgery, Rudong People’s Hospital, Nantong 226400, Jiangsu Province, China
Hai-Bin Zheng, Department of General Surgery, Putuo Renji Hospital, Zhoushan 316100, Zhejiang Province, China
Co-first authors: Xiao-Mei Chang and Bing-Hua Cai.
Author contributions: Chang XM and Cai BH contributed to research design, data collection, data analysis, and paper writing, and they contributed equally to this article as co-first authors; Zheng HB was responsible for research design, funding application, manuscript review and editing, communication coordination, ethical review, copyright and licensing, and follow-up.
Institutional review board statement: The research was reviewed and approved by the Institutional Review Board of Rudong People’s Hospital, No. 2025-502.
Clinical trial registration statement: This study has not yet been registered in a clinical trials registry.
Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: No other data available.
Corresponding author: Hai-Bin Zheng, Associate Chief Physician, Department of General Surgery, Putuo Renji Hospital, No. 90 Gongxia Road, Putuo District, Zhoushan 316100, Zhejiang Province, China. 13706809729@163.com
Received: November 4, 2025 Revised: December 5, 2025 Accepted: January 20, 2026 Published online: April 15, 2026 Processing time: 154 Days and 23.2 Hours
Abstract
BACKGROUND
Colorectal cancer (CRC) surgery elicits a significant physiological stress response, characterized by increased catabolism and systemic immunosuppression, which collectively exacerbate pre-existing or postoperative malnutrition. This hypermetabolic state accelerates muscle breakdown, impairs wound healing, and heightens susceptibility to infections. Early enteral nutrition (EEN) is strongly recommended within enhanced recovery protocols to mitigate these effects by providing essential nutrients, preserving gut barrier function, and modulating immune activity. However, conventional EEN delivery often follows a standardized, one-size-fits-all approach, lacking the necessary personalization to address individual variations in metabolic demand, nutritional status, and gastrointestinal tolerance, thereby limiting its potential efficacy and patient-specific benefits.
AIM
To investigate the effect of the PIPOST model combined with EEN on postoperative recovery in CRC patients.
METHODS
A randomized controlled trial was conducted. A total of 120 patients undergoing CRC surgery were randomly assigned to a control group (n = 60) receiving conventional EEN or an observation group (n = 60) receiving PIPOST model-based EEN management. Nutritional indicators, immune function, gastrointestinal recovery, complications, and hospital stay were compared.
RESULTS
The observation group showed significantly higher levels of albumin, prealbumin, and transferrin at postoperative day 7 (P < 0.05). CD4+/CD8+ ratio and natural killer cell activity were also significantly higher in the observation group (P < 0.05). Time to first flatus and time to first defecation were shorter, overall complication rate was lower (16.7% vs 30.0%, P < 0.05), and hospital stay was significantly shortened in the observation group (P < 0.05).
CONCLUSION
EEN guided by the PIPOST model significantly improves postoperative nutritional status, immune function, and gastrointestinal recovery, and reduces complications and hospital stay in CRC patients.
Core Tip: This article demonstrates that implementing a structured PIPOST model for early enteral nutrition in post-colorectal cancer surgery patients significantly enhances recovery. Compared to conventional early enteral nutrition, the PIPOST-guided approach led to marked improvements in nutritional biomarkers (albumin, prealbumin, and transferrin), immune function (CD4+/CD8+ ratio and natural killer cell activity), and gastrointestinal recovery, while reducing complication rates and shortening hospital stays. This study provides evidence for a systematic and precise nutritional support framework in postoperative care.
