The impact of ERAS-based nursing interventions on postoperative complication management and prognosis in early gastrointestinal tumor endoscopic resection: a prospective randomized controlled study.

Abstract

Objective: This study aimed to evaluate the effectiveness of Enhanced Recovery After Surgery (ERAS)-based nursing interventions in improving postoperative recovery, reducing complications, and enhancing patient satisfaction and quality of life in patients undergoing endoscopic resection for early gastrointestinal tumors.

Methods: A single-center, randomized, single-blind controlled trial was conducted from October 2023 to October 2024 at a tertiary hospital. A total of 120 patients with early-stage gastrointestinal tumors scheduled for endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) were randomly assigned to the ERAS group (n = 60) or the control group (NC, n = 60). Data collection included Comprehensive Complication Index (CCI), Visual Analog Scale (VAS), Six-Minute Walk Test (6MWT), EORTC QLQ-C30, SF-36, patient satisfaction, and length of hospital stay. Statistical analyses included repeated measures ANOVA and chi-square tests, with a significance threshold of P < 0.05.

Results: Compared to the NC group, the ERAS group demonstrated significantly lower CCI scores and fewer Clavien-Dindo ≥ III complications at 3 days, 2 weeks, and 3 months postoperatively (P < 0.05). The ERAS group also reported shorter hospital stays (4.8 ± 1.5 vs. 6.3 ± 1.8 days, P < 0.001). VAS scores in the ERAS group were significantly lower at 24 h and 3 days postoperatively (P < 0.001), with differences diminishing over time. Functional recovery, measured by 6MWT, was significantly better in the ERAS group at all time points except 12 months. HRQoL scores in the ERAS group were significantly higher at 3 months, particularly in functional and symptom dimensions (P < 0.05), and have higher patient satisfaction rates across all follow-up time points (P < 0.05).

Conclusion: ERAS-based nursing interventions significantly improved postoperative recovery, reduced complications, shortened hospital stays, and enhanced patient satisfaction and quality of life in patients undergoing minimally invasive endoscopic resection for early gastrointestinal tumors. These findings support the integration of ERAS principles into nursing care protocols to optimize surgical outcomes.