Zhao BH, Bao CX. Enhanced recovery after surgery pathways and postoperative gastrointestinal function in colorectal cancer: A prospective cohort study. World J Gastrointest Surg 2026; 18(2): 115050 [DOI: 10.4240/wjgs.v18.i2.115050]
Corresponding Author of This Article
Chun-Xiao Bao, MD, Department of Rehabilitation Medicine, Shaoxing Central Hospital, No. 1 Huayu Road, Keqiao District, Shaoxing 312030, Zhejiang Province, China. baocx1197@163.com
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Gastroenterology & Hepatology
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Prospective Study
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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/
Feb 27, 2026 (publication date) through Feb 26, 2026
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Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Zhao BH, Bao CX. Enhanced recovery after surgery pathways and postoperative gastrointestinal function in colorectal cancer: A prospective cohort study. World J Gastrointest Surg 2026; 18(2): 115050 [DOI: 10.4240/wjgs.v18.i2.115050]
World J Gastrointest Surg. Feb 27, 2026; 18(2): 115050 Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.115050
Enhanced recovery after surgery pathways and postoperative gastrointestinal function in colorectal cancer: A prospective cohort study
Bai-Hui Zhao, Chun-Xiao Bao
Bai-Hui Zhao, Department of Rehabilitation Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Bai-Hui Zhao, Chun-Xiao Bao, Department of Rehabilitation Medicine, Shaoxing Central Hospital, Shaoxing 312030, Zhejiang Province, China
Author contributions: Zhao BH conceived and designed the study, supervised data collection, and drafted the manuscript; Bao CX contributed to patient recruitment, clinical data acquisition, and statistical analysis. Both authors participated in data interpretation, manuscript revision, and approved the final version for publication; Zhao BH is the guarantor of the work and takes full responsibility for the integrity of the data and the accuracy of the analysis.
Institutional review board statement: This study has been reviewed and approved by the Medical Ethics Committee of Zhejiang University of Traditional Chinese Medicine.
Clinical trial registration statement: This study was conducted prospectively. According to the characteristics of the study design, it was not registered in a clinical trial registry prior to initiation.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement-checklist of items.
Data sharing statement: There is no additional data available.
Corresponding author: Chun-Xiao Bao, MD, Department of Rehabilitation Medicine, Shaoxing Central Hospital, No. 1 Huayu Road, Keqiao District, Shaoxing 312030, Zhejiang Province, China. baocx1197@163.com
Received: November 4, 2025 Revised: December 3, 2025 Accepted: December 22, 2025 Published online: February 27, 2026 Processing time: 113 Days and 22.2 Hours
Abstract
BACKGROUND
Enhanced recovery after surgery (ERAS) pathways, integrated with systematic rehabilitation interventions, are essential for promoting recovery of gastrointestinal function and improving quality of life (QoL) after colorectal cancer surgery.
AIM
To explore how ERAS pathways with rehabilitation affect postoperative recovery of gastrointestinal function and QoL in patients with colorectal cancer.
METHODS
In this prospective cohort study, 122 patients undergoing colorectal cancer surgery between January 2022 and June 2024 were randomly divided into experimental (ERAS + rehabilitation, n = 61) and control (routine nursing, n = 61) groups. The experimental group received a comprehensive ERAS pathway, preoperative carbohydrate loading, targeted fluid management, multimodal analgesia, early feeding, and structured rehabilitation training. The control group received traditional perioperative management. Gastrointestinal function recovery indicators, pain scores, complication rates, and QoL were compared between the groups.
RESULTS
The ERAS group showed significantly shorter recovery time for gastrointestinal peristalsis, earlier first exhaust and defecation times, lower pain scores, and fewer complications (all P < 0.05). Rehabilitation training compliance was 91.8%. The ERAS group also had significantly better QoL scores in the physical, psychological, and gastrointestinal domains (P < 0.05). Multivariate logistic regression analysis confirmed that ERAS was an independent protective factor against delayed gastrointestinal recovery (odds ratio = 0.32, 95% confidence interval: 0.12-0.85). Subgroup analysis confirmed its effectiveness in improving inflammation and barrier indicators.
CONCLUSION
ERAS pathways with rehabilitation training can enhance postoperative gastrointestinal recovery, alleviate pain, reduce complications, and improve the QoL in patients with colorectal cancer, showing significant clinical and rehabilitative value.
Core Tip: Enhanced recovery after surgery (ERAS) pathways integrated with structured rehabilitation training significantly accelerate postoperative gastrointestinal function recovery in patients undergoing colorectal cancer surgery. This prospective cohort study showed that ERAS reduced the time to first exhaustion and defecation, lowered pain scores, decreased postoperative complications, and improved quality of life across the physical, emotional, and gastrointestinal domains. These findings show the clinical and rehabilitative value of combining ERAS protocols with targeted rehabilitation strategies to optimize postoperative recovery and promote evidence-based, patient-centred perioperative management.
