Longitudinal analysis of postoperative symptom clusters in patients undergoing esophageal cancer surgery

Esophageal cancer (EC) is highly prevalent in China. Despite undergoing radical surgery, patients frequently experience multiple postoperative symptoms, and their prognosis remains relatively poor. This study investigates the types of symptom clusters, the composition of symptoms within these symptom clusters, and dynamic changes in EC patients at different time points after surgery, aiming to provide theoretical guidance for symptom management in esophagectomy patients.

A convenience sampling method was employed to recruit 218 patients with EC scheduled for surgical treatment in the thoracic surgery department of a tertiary hospital in Shanghai between January 2023 and January 2024 as study participants. Participants were assessed using a general information questionnaire and the Anderson Symptom Assessment Scale at 4-7 days (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after surgery, and symptom clusters were identified through exploratory factor analysis.

The incidence and severity of symptoms varied across different postoperative time points, with pain, fatigue, restless sleep, distress, and dry mouth consistently demonstrating higher incidence and severity. Among these clusters, the Emotional-Stress Symptom Cluster and Cognitive-Gastrointestinal Symptom Cluster persisted during the first three time points, whereas only the emotional stress cluster remained at 6 months (T4) postoperatively.

Postoperative EC patients experience multiple symptom clusters, with some clusters persisting over time. The composition and severity of these clusters vary across different longitudinal time points. Healthcare providers should closely monitor symptom changes, enhance symptom management strategies during the perioperative period, and develop tailored symptom management plans to mitigate the impact of surgery-related symptoms on patients.