Lu CP, Gao Y, Zhang ZH. Enhanced recovery after surgery continuity nursing in elderly gastric cancer patients. World J Gastrointest Surg 2025; 17(5): 103340 [DOI: 10.4240/wjgs.v17.i5.103340]
Corresponding Author of This Article
Cai-Ping Lu, BSc, Doctor, Department of Medicine, Henan Vocational University of Science and Technology, No. 6 East Wenchang Avenue, Zhoukou 466000, Henan Province, China. hkzdhuli111@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
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/
World J Gastrointest Surg. May 27, 2025; 17(5): 103340 Published online May 27, 2025. doi: 10.4240/wjgs.v17.i5.103340
Enhanced recovery after surgery continuity nursing in elderly gastric cancer patients
Cai-Ping Lu, Ying Gao, Zhi-Hong Zhang
Cai-Ping Lu, Department of Medicine, Henan Vocational University of Science and Technology, Zhoukou 466000, Henan Province, China
Ying Gao, Department of General Surgery, Zhoukou First People’s Hospital, Zhoukou 466000, Henan Province, China
Zhi-Hong Zhang, Department of Oncology, Zhoukou Hospital of Traditional Chinese Medicine, Zhoukou 466000, Henan Province, China
Author contributions: Lu CP and Gao Y designed the experiments, conducted clinical data collection, conducted the collation, statistical analysis, and wrote the original manuscript and revised the paper; Zhang ZH performed postoperative follow-up and recorded the data; All authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the Zhoukou First People’s Hospital.
Informed consent statement: The Ethics Committee agreed to waive informed consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cai-Ping Lu, BSc, Doctor, Department of Medicine, Henan Vocational University of Science and Technology, No. 6 East Wenchang Avenue, Zhoukou 466000, Henan Province, China. hkzdhuli111@163.com
Received: December 27, 2024 Revised: March 6, 2025 Accepted: April 17, 2025 Published online: May 27, 2025 Processing time: 146 Days and 19.1 Hours
Abstract
BACKGROUND
Gastric cancer predominantly affects the elderly, who face significant challenges due to high postoperative complications and stress. These challenges include comorbidities, reduced physiological reserves, and increased risks of infections and delayed healing. Traditional postoperative care often falls short in addressing these issues effectively. Enhanced recovery after surgery (ERAS) principles have revolutionized surgical care by reducing stress and promoting recovery through a holistic approach. ERAS emphasizes preoperative optimization, intraoperative care, and postoperative rehabilitation tailored to patient needs. Despite its recognized benefits, the impact of continuity nursing care within the ERAS framework on elderly gastric cancer patients remains underexplored. This study examines the influence of ERAS-based continuity nursing care on postoperative satisfaction, inflammation, stress, and quality of life in elderly patients undergoing gastric cancer resection.
AIM
To investigate the effects of ERAS-based continuity nursing care on postoperative satisfaction, inflammation, stress, and quality of life in elderly gastric cancer patients.
METHODS
A retrospective cohort analysis was conducted on 322 elderly patients who underwent gastric cancer resection between January 2020 and January 2022. Patients were assigned to a routine care group (n = 156) or an ERAS-control (ERAS-C) group (n = 166). Data collected included demographic information, inflammatory and stress markers, satisfaction scores using the patient satisfaction questionnaire-18, and quality of life measured using the European Organization for Research and Treatment of Cancer 22-item quality of life questionnaire specific to gastric cancer.
RESULTS
The ERAS-C group exhibited significantly lower postoperative interleukin-6 levels than the routine care group (12.97 ± 4.02 pg/mL vs 14.37 ± 3.86 pg/mL; P = 0.002). This finding indicates that the ERAS-C group experienced reduced inflammation. The ERAS-C group also had a higher cluster of differentiation (CD) 4:CD8 ratio than the routine care group (2.34 ± 0.35 vs 2.13 ± 0.61; P < 0.001), suggesting the former’s enhanced immune response. Postoperative stress markers, including norepinephrine, cortisol, and aldosterone, were significantly lower in the ERAS-C group than in the routine care group (P < 0.05 for all). Compared with the routine care group, the ERAS-C group showed increased nursing satisfaction scores (80.36 ± 7.24 vs 75.23 ± 7.03; P < 0.001) and improved quality of life indicators, such as reduced dysphagia and pain, (P < 0.05). The ERAS-C group also experienced fewer complications than the routine care group (5.42% vs 11.54%, P = 0.048).
CONCLUSION
Continuity nursing care within the ERAS framework significantly enhances postoperative outcomes for elderly gastric cancer patients by reducing inflammation, stress, and complications while improving satisfaction and quality of life.
Core Tip: Enhanced recovery after surgery (ERAS) principles, when integrated with continuity nursing care, significantly improve postoperative outcomes in elderly gastric cancer patients. This study demonstrates that ERAS-based continuity nursing reduces inflammation and stress while enhancing immune response and patient satisfaction. Key findings include lower interleukin-6 levels, higher cluster of differentiation (CD) 4:CD8 ratios, reduced postoperative complications, and improved quality of life. These results highlight the potential of ERAS protocols to address the unique challenges faced by elderly patients undergoing gastric cancer resection, providing a robust foundation for future multi-center studies.
