Abstract
BACKGROUND: Postoperative ileus is a common complication after colorectal cancer surgery, affecting recovery quality and hospital stay duration. Early activity intervention, as an important component of enhanced recovery after surgery, requires systematic evaluation of its exact effects on intestinal motility recovery and multidimensional impact. AIM: To comprehensively investigate the effects of early activity intervention on intestinal motility recovery and related indicators in patients after colorectal cancer surgery. METHODS: Using a retrospective comparative study design, 80 patients who underwent colorectal cancer surgery in our hospital from August 2023 to December 2024 were retrospectively analyzed and divided into experimental and control groups with 40 patients each based on the postoperative care protocols they received. The control group had received routine postoperative care, while the experimental group had additionally received a systematic early activity intervention program, including bed-based passive activities within 6 hours post-surgery, active bed exercises from 6-24 hours, bedside activities from 24-48 hours, and in-ward walking after 48 hours. Assessment indicators were retrospectively collected from medical records and included intestinal motility recovery, inflammatory stress response, postoperative complications, enteral nutrition tolerance, pain scores, nursing workload, patient psychological state, sleep quality, and nursing satisfaction. RESULTS: The experimental group demonstrated significantly shorter time to first flatus (48.2 ± 10.6 hours vs 67.5 ± 12.3 hours, P < 0.001) and first defecation (72.4 ± 13.8 hours vs 94.6 ± 15.7 hours, P < 0.001); lower abdominal distension scores at 72 hours post-surgery (2.1 ± 0.6 vs 3.4 ± 0.8, P < 0.001); and reduced overall complication rates (7.5% vs 20.0%, P = 0.039). Inflammatory markers including C-reactive protein, interleukin-6, and tumor necrosis factor-α were significantly lower in the experimental group (P < 0.001). Pain scores at 72 hours post-surgery (1.8 ± 0.5 vs 3.2 ± 0.8, P < 0.001) and additional analgesic requests (2.3 ± 1.1 times vs 4.8 ± 1.6 times, P < 0.001) were markedly reduced. Good enteral nutrition tolerance was higher (90.0% vs 72.5%, P = 0.045), with earlier initiation of liquid diet (62.3 ± 9.6 hours vs 83.7 ± 12.4 hours, P < 0.001). Daily nursing time from postoperative day 3-7 (78.3 ± 15.6 minutes vs 96.2 ± 20.3 minutes, P < 0.001) and extra interventions for complications (1.2 ± 1.0 times/patient vs 2.8 ± 1.5 times/patient, P < 0.001) were reduced. Anxiety and depression scores were lower, sleep quality improved (Pittsburgh Sleep Quality Index: 6.3 ± 1.4 vs 9.2 ± 2.1, P < 0.001), and nursing satisfaction was significantly higher (92.6 ± 5.8 vs 85.3 ± 7.2, P < 0.001). CONCLUSION: Early activity intervention is a safe and effective non-pharmacological measure that not only significantly promotes intestinal motility recovery in patients after colorectal cancer surgery but also reduces inflammatory response and postoperative pain, improves enteral nutrition tolerance, decreases postoperative complication rates, reduces nursing workload, improves patient psychological state and sleep quality, increases nursing satisfaction, and shortens hospital stay. This comprehensive intervention, being easy to implement and cost-effective, is worthy of widespread application in clinical practice.