The relationship between preoperative depression and anxiety and postoperative recovery in patients undergoing gastrointestinal cancer surgery: a prospective cohort study

Psychological distress, particularly anxiety and depression, is common among patients undergoing cancer surgery and may adversely affect recovery. However, the relationship between these factors and early postoperative outcomes in gastrointestinal (GI) cancer surgery has not been sufficiently investigated. This study aimed to examine the association of preoperative depression and anxiety symptoms with early postoperative recovery in patients undergoing oncological GI surgery. A prospective cohort study was conducted at a university hospital in Eastern Türkiye between February 2023 and January 2025. A total of 162 patients scheduled for GI cancer surgery participated. Preoperative psychological status was assessed using the Hospital Anxiety and Depression Scale (HADS). On postoperative day three, recovery was evaluated using the Quality of Recovery-40 (QoR-40), pain with the Numeric Rating Scale (NRS), and data on gastrointestinal function and ambulation were collected. Patients who experienced depressive symptoms before surgery demonstrated poorer overall recovery, reduced physical independence, lower perceived psychological support, reduced emotional status, and limited ambulation compared to those without such symptoms. Similarly, individuals with anxiety reported reduced physical functioning and emotional support, along with more severe pain in the early postoperative phase. No meaningful differences were observed in gastrointestinal function between groups. Additionally, higher body mass index was generally associated with better perceived recovery. Preoperative anxiety and depression are associated with impaired early postoperative recovery among patients undergoing GI cancer surgery. Integrating routine psychological screening and targeted psychosocial interventions into preoperative nursing care may help identify vulnerable patients and improve recovery outcomes No patient or public contribution.