Objective To explore the effects of enhanced recovery after surgery (ERAS) combined with Bacillus licheniformis on postoperative recovery time in patients undergoing colorectal cancer surgery.

Methods A retrospective cohort study was conducted. Clinical data of patients diagnosed with colorectal cancer treated in the Department of Colorectal Surgery of Huzhou First People's Hospital from January 2023 to March 2024 were retrospectively collected and analyzed. All patients received oral live Bacillus licheniformis after surgery. According to differences in perioperative nursing intervention methods, the patients were divided into a study group and a control group. The control group received routine perioperative nursing, while the study group was managed with ERAS protocols including modified preoperative bowel preparation, intraoperative active temperature management, postoperative drainage tube management, stepwise nutritional management and early mobilization. Postoperative recovery time, psychological status assessed by The Depression Anxiety Stress Scales-21(DASS-21), gastrointestinal complications, quality of life evaluated by the Chinese version of Functional Assessment of Cancer Therapy-Colorectal (FACT-C), and nursing satisfaction were compared between the two groups.

Results A total of 82 patients were included (44 in the study group and 38 in the control group) The time to first ambulation (1.57±0.36 vs. 1.91±0.52) d, time to first flatus (2.35±0.53 vs. 2.62±0.49) d, time to first defecation (2.55±0.42 vs. 2.81±0.56) d and length of hospital stay (8.15±0.46 vs. 8.71±1.03) d in the study group were significantly shorter than those in the control group (P<0.05). After intervention, all dimension scores of DASS-21 in the study group were markedly lower than those in the control group: anxiety (7.45±2.17 vs. 9.11±1.90), depression (5.42±1.23 vs. 6.17±0.97), stress (8.21±1.62 vs. 9.44±1.50) (P<0.05). The incidence of gastrointestinal function-related complications such as postoperative diarrhea and abdominal distension was lower in the study group (9.09% vs. 26.32%, P<0.05). At 3 months after surgery, all dimension scores and total score of FACT-C were higher in the study group than the control group: physical well-being (68.23±5.67 vs. 65.28±6.22), social/family well-being (69.25±4.92 vs. 67.00±5.18), emotional well-being (65.29±7.28 vs. 61.70±6.83), functional well-being (62.19±6.83 vs. 58.74±5.12), additional concerns (61.72±7.38 vs. 58.28±5.52), total score (65.34±7.36 vs. 62.20±6.15) (P<0.05). The overall nursing satisfaction rate in the study group (95.45% vs. 81.58%) was significantly higher than that in the control group (P<0.05).

Conclusion For postoperative patients with colorectal cancer treated with Bacillus licheniformis, ERAS intervention is associated with shorter recovery time, lower incidence of gastrointestinal complications, superior short-term quality of life and higher patient satisfaction.

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