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Published on: June 13, 2025
Integrated psychosocial, sleep, and nutritional support improves postoperative recovery, immune modulation, and
1Department of General Surgery, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou City, Jiangsu Province, China.
Background:
Patients undergoing low rectal cancer resection often experience psychological distress, sleep disturbance, nutritional decline, and functional impairment. Evidence for comprehensive supportive interventions is limited.
Methods:
In this single-center RCT (n = 188), patients were randomized 1:1 to an integrative psychosocial-sleep-nutrition program or ERAS-based standard care. Outcomes included psychological distress (BDI-II, BAI), sleep quality (PSQI), anorectal (LARS) and sexual function (IIEF-5/FSFI), postoperative inflammatory markers, recovery, and 2-year survival.
Results:
At 24 months, intervention patients showed greater reductions in BDI-II (-5.2), BAI (-3.8), and PSQI (-2.9), lower major LARS prevalence (28.7 % vs 46.2 %), and higher IIEF-5/FSFI scores. Postoperative CRP, IL-6, and TNF-α were lower (p < 0.001). Two-year DFS and OS were 90.3 % vs 79.2 % (p = 0.028) and 93.6 % vs 82.5 % (p = 0.019), respectively.
Conclusions:
Multimodal psychosocial, sleep, and nutritional support improves psychological, functional, immunologic, and survival outcomes after low rectal cancer surgery.
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