Failure mode and effects analysis nursing model improves recovery and quality of life post-laparoscopic extended radical colectomy for colorectal cancer

BACKGROUND Postoperative gastrointestinal recovery is a critical factor influencing patient rehabilitation. AIM To investigate the effects of conventional care compared with the failure mode and effects analysis (FMEA) protocol on postoperative recovery in patients undergoing surgery. METHODS A retrospective cohort study analyzed 225 patients with colorectal cancer (conventional care group: n = 122; FMEA group: n = 103) treated between June 2021 and June 2024. Outcomes included gastrointestinal recovery (time to flatus/bowel movement and diet tolerance), functional capacity (6-minute walk distance test and sit-to-stand test), complications, quality of life (General Comfort Questionnaire, Barthel index, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30), and satisfaction. RESULTS The FMEA group demonstrated significantly accelerated recovery: Shorter hospital stays (4.49 ± 0.38 days vs 4.66 ± 0.42 days, P = 0.002), earlier flatus (18.58 ± 1.86 hours vs 19.09 ± 1.93 hours, P = 0.045), and improved 6-minute walk distance at 8 weeks (526.16 ± 88.71 m vs 495.29 ± 94.82 m, P = 0.013). Complication rates decreased (nausea/vomiting: 12.62% vs 22.95%, P = 0.046; bowel obstruction: 2.91% vs 10.66%, P = 0.024). Quality of life metrics significantly favored FMEA: Total comfort score (91.66 ± 4.71 vs 89.27 ± 4.87, P < 0.001), Barthel index (67.93 ± 3.19 vs 66.71 ± 3.35, P = 0.006), and higher “very satisfied” rates (61.17% vs 47.54%, P = 0.041). CONCLUSION FMEA-based nursing significantly enhances postoperative functional recovery, reduces complications, and improves quality of life in patients undergoing extended colectomy.