Enhanced recovery after surgery pathways and postoperative gastrointestinal function in colorectal cancer: A prospective cohort study

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.