Abstract
BACKGROUND: Postoperative gastrointestinal recovery is a critical factor influencing patient rehabilitation. AIM: To investigate the effects of conventional care compared with the failure mode and effects analysis (FMEA) protocol on postoperative recovery in patients undergoing surgery. METHODS: A retrospective cohort study analyzed 225 patients with colorectal cancer (conventional care group: n = 122; FMEA group: n = 103) treated between June 2021 and June 2024. Outcomes included gastrointestinal recovery (time to flatus/bowel movement and diet tolerance), functional capacity (6-minute walk distance test and sit-to-stand test), complications, quality of life (General Comfort Questionnaire, Barthel index, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30), and satisfaction. RESULTS: The FMEA group demonstrated significantly accelerated recovery: Shorter hospital stays (4.49 ± 0.38 days vs 4.66 ± 0.42 days, P = 0.002), earlier flatus (18.58 ± 1.86 hours vs 19.09 ± 1.93 hours, P = 0.045), and improved 6-minute walk distance at 8 weeks (526.16 ± 88.71 m vs 495.29 ± 94.82 m, P = 0.013). Complication rates decreased (nausea/vomiting: 12.62% vs 22.95%, P = 0.046; bowel obstruction: 2.91% vs 10.66%, P = 0.024). Quality of life metrics significantly favored FMEA: Total comfort score (91.66 ± 4.71 vs 89.27 ± 4.87, P < 0.001), Barthel index (67.93 ± 3.19 vs 66.71 ± 3.35, P = 0.006), and higher "very satisfied" rates (61.17% vs 47.54%, P = 0.041). CONCLUSION: FMEA-based nursing significantly enhances postoperative functional recovery, reduces complications, and improves quality of life in patients undergoing extended colectomy.