Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Surg. Mar 27, 2026; 18(3): 114661
Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.114661
Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.114661
Evaluation of the recovery speed and safety of fastest recovery after surgery vs enhanced recovery after surgery in patients undergoing gastrointestinal tumor surgery
De-Hua Zhou, Rui Li, Nan Zhang, Yi-Ping Ni, Han-Rong Liu, Zhuo Chen, Zhen-Xing Huang, Cheng Chang, Zhi-Hao Shi, Yu-Xiang Xie, Shao-Hua Zhang, Qi-Zhi Liu, Xiao-Huang Tu, Department of Gastrointestinal Surgery, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai 200434, China
Ding-Tao Xu, Department of Anesthesia and Perioperative Medicine, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai 200434, China
Shu Zhang, Department of Surgery, Fudan University Shanghai Cancer Center, Shanghai 200000, China
Ru-Hong Shi, Ting-Ting Ge, Hui-Ming Zhou, Min-Jun Zhou, Department of Nursing, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai 200434, China
Co-first authors: De-Hua Zhou and Rui Li.
Co-corresponding authors: Qi-Zhi Liu and Xiao-Huang Tu.
Author contributions: Zhou DH and Li R contributed equally to this work as co-first authors, with the former author being primarily responsible for data curation, formal analysis, and original drafting, and the latter author coordinating methodology development, investigation, and manuscript revision; Xu DT contributed to anesthesia and perioperative management; Zhang S and Zhang N contributed to statistical analysis; Ni YP, Liu HR and Chen Z contributed to patient follow-up and outcome assessment; Huang ZX, Chang C, and Shi ZH contributed to inflammatory marker analysis and data interpretation; Xie YX and Zhang SH contributed to nursing and protocol execution; Shi RH, Ge TT, Zhou HM, and Zhou MJ contributed to the collective performance of preoperative evaluation, dietary recovery, and satisfaction surveys; Liu QZ and Tu XH served as co-corresponding authors and jointly supervised the study design and funding acquisition, along with providing critical intellectual revisions.
Supported by Hongkou District Health Commission of Shanghai Municipality, No. Hongwei2303-10; the Key Project of the Discipline Promotion Program at Shanghai Fourth People’s Hospital, No. SY-XKZT-2023-2001; the Nursing Special Project of the Discipline Promotion Program at Shanghai Fourth People’s Hospital, No. SY-XKZT-2025-2009; and the Talent Promotion Program at Shanghai Fourth People’s Hospital, No. SY-XKZT-2024-3002.
Institutional review board statement: This retrospective study was conducted in accordance with the ethical standards of the Declaration of Helsinki and was approved by the Ethics Committee of Shanghai Fourth People’s Hospital (Approval No. SYLL2023013).
Informed consent statement: This study is a retrospective cohort study. All data were obtained from the hospital’s electronic medical record system and underwent rigorous anonymization procedures, with no new collection of human tissues or blood samples. Given the retrospective design and the use of fully anonymized data, the risk to participants was minimal. Furthermore, as the research could not be practically conducted if individual informed consent were required, the ethics committee granted a formal waiver of informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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 datasets are available from the corresponding author upon reasonable request.
Corresponding author: Xiao-Huang Tu, MD, PhD, Chief Physician, Professor, Department of Gastrointestinal Surgery, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, No. 1279 Sanmen Road, Hongkou District, Shanghai 200434, China.
Received: September 26, 2025
Revised: November 19, 2025
Accepted: January 16, 2026
Published online: March 27, 2026
Processing time: 183 Days and 0.1 Hours
Revised: November 19, 2025
Accepted: January 16, 2026
Published online: March 27, 2026
Processing time: 183 Days and 0.1 Hours
Core Tip
Core Tip: This study introduces fastest recovery after surgery as an optimized protocol building upon enhanced recovery after surgery. In patients who underwent gastrointestinal tumor surgery, fastest recovery after surgery achieved a remarkably short median postoperative stay of approximately 22.4 hours without increasing complication rates; moreover, it also significantly improved early quality of life and patient satisfaction. This effect represents a significant advancement in perioperative care, thus demonstrating that further acceleration of recovery beyond traditional enhanced recovery after surgery is both feasible and safe in carefully selected patients.