A multidomain perioperative intervention improves postoperative recovery and clinical outcomes after abdominoperineal resection for low rectal cancer: A randomized controlled trial - 10/04/26
Abstract |
Background |
Abdominoperineal resection (APR) for low rectal cancer is associated with substantial morbidity and psychosocial burden. This randomized controlled trial evaluated whether integrating resilience-oriented cognitive behavioral therapy and behavioral sleep regulation into enhanced recovery after surgery (ERAS) improves clinical and oncologic outcomes.
Methods |
In this single-center trial, 192 patients undergoing curative APR were randomized to standard ERAS or ERAS plus a structured multidomain behavioral intervention. The primary endpoint was 2-year disease-free survival (DFS). Key secondary outcomes included recovery metrics, clinically significant complications, inflammatory markers, and patient-reported outcomes.
Results |
The intervention group demonstrated faster bowel recovery, shorter hospitalization, fewer Clavien–Dindo grade ≥ II complications, and lower postoperative CRP, IL-6, and TNF-α levels. Two-year DFS and overall survival favored the intervention.
Conclusions |
Integrating resilience- and sleep-based interventions into ERAS was associated with improved recovery, attenuated perioperative inflammation, and superior 2-year DFS after APR.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | A randomized controlled trial evaluated a multidomain perioperative intervention after abdominoperineal resection. |
• | The intervention accelerated postoperative recovery and reduced clinically significant morbidity. |
• | Postoperative inflammatory responses were attenuated in the intervention group. |
• | Functional outcomes improved during follow-up without increasing perioperative risk. |
• | Perioperative recovery after major colorectal surgery may be modifiable beyond standard ERAS care. |
Keywords : Abdominoperineal resection, Perioperative care, Enhanced recovery after surgery, Postoperative recovery, Surgical morbidity, Randomized controlled trial
Plan
Vol 256
Article 116931- juin 2026 Retour au numéro
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