Zhou NL, Liu AN, Yu SH, Li WS. Association among preoperative comorbidities, targeted nursing interventions, and postoperative recovery in patients undergoing total gastrectomy for gastric cancer. World J Gastrointest Oncol 2026; 18(9): 119825 [DOI: 10.4251/wjgo.119825]
Corresponding Author of This Article
An-Nuo Liu, School of Nursing, Anhui Medical University, No. 2227 Hangbuhe Avenue, Hefei 230032, Anhui Province, China. liuannuo@ahmu.edu.cn
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Medicine, Research & Experimental
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research-article
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Zhou NL, Liu AN, Yu SH, Li WS. Association among preoperative comorbidities, targeted nursing interventions, and postoperative recovery in patients undergoing total gastrectomy for gastric cancer. World J Gastrointest Oncol 2026; 18(9): 119825 [DOI: 10.4251/wjgo.119825]
World J Gastrointest Oncol. Sep 15, 2026; 18(9): 119825 Published online Sep 15, 2026. doi: 10.4251/wjgo.119825
Association among preoperative comorbidities, targeted nursing interventions, and postoperative recovery in patients undergoing total gastrectomy for gastric cancer
Na-Li Zhou, An-Nuo Liu, Shi-Hui Yu, Wei-Song Li
Na-Li Zhou, An-Nuo Liu, School of Nursing, Anhui Medical University, Hefei 230032, Anhui Province, China
Na-Li Zhou, Shi-Hui Yu, Department of Gastrointestinal, Hernia and Pediatric Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
An-Nuo Liu, Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Wei-Song Li, Department of Pediatric Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Author contributions: Zhou NL and Liu AN designed the research study and they has been involved in drafting the manuscript; Zhou NL, Yu SH and Li WS performed the research; Yu SH and Li WS collected and analyzed the data; all authors have been involved in revising it critically for important intellectual content and give final approval of the version to be published; and all authors have participated sufficiently in the work to take public responsibility for appropriate portions of the content and agreed to be accountable for all aspects of the work in ensuring that questions related to its accuracy or integrity.
AI contribution statement: The entirety or any portion of the main text of the manuscript (Abstract, Introduction, Materials and Methods, Results, Discussion, and Conclusion) and Answer reviewer not AI-generated.
Supported by Major Project of Humanities and Social Sciences of the Education Department of Anhui Province, No. 2025AHGXSK20040.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the First Affiliated Hospital of Anhui Medical University (Approval No. PJ2025-12-34).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at liuannuo@ahmu.edu.cn.
Corresponding author: An-Nuo Liu, School of Nursing, Anhui Medical University, No. 2227 Hangbuhe Avenue, Hefei 230032, Anhui Province, China. liuannuo@ahmu.edu.cn
Received: March 13, 2026 Revised: April 9, 2026 Accepted: May 21, 2026 Published online: September 15, 2026 Processing time: 165 Days and 5.5 Hours
Abstract
BACKGROUND
Patients undergoing total gastrectomy for gastric cancer (GC) often have varying degrees of preoperative comorbidities that can influence perioperative care and postoperative recovery. However, the relationships among comorbidity severity, perioperative nursing processes, and early recovery outcomes remain unclear.
AIM
To examine the associations among preoperative comorbidities, perioperative nursing process indicators, and postoperative recovery after total gastrectomy for GC.
METHODS
This retrospective cohort study included data from patients who underwent total gastrectomy for GC. Perioperative nursing process indicators included preoperative waiting time, times to first ambulation, oral intake, and nasogastric tube removal. Postoperative recovery endpoints included postoperative recovery time and length of hospital stay.
RESULTS
Higher comorbidity severity was associated with worse baseline nutritional parameters and a higher American Society of Anesthesiologists physical status. Patients with severe comorbidities tended to experience delayed perioperative nursing events. After adjustment, an inverse association was observed in the fully adjusted model. Multivariate analysis revealed that the time to first oral intake was an independent predictor of delayed recovery.
CONCLUSION
Severe preoperative comorbidities were associated with delayed perioperative nursing milestones but were not associated with delayed postoperative recovery in the expected positive direction after adjustment. Time to first oral intake exhibited a strong independent association with delayed recovery.
Core Tip: This retrospective cohort study investigates the relationship between preoperative comorbidity severity, perioperative nursing processes, and early recovery outcomes in 174 gastric cancer patients undergoing total gastrectomy. While higher comorbidity severity correlated with delayed key nursing events (e.g., time to first oral intake and ambulation), it was not an independent predictor of delayed postoperative recovery after multivariate adjustment. The analysis identified time to first oral intake as a significant independent predictor of delayed recovery.
