Impact of ERAS pathway-based perioperative management on postoperative recovery and psychological status in thyroid cancer surgery patients: A retrospective study

Enhanced recovery after surgery (ERAS) protocols have demonstrated benefits in various surgical specialties, but their impact on psychological outcomes in thyroid cancer patients remains underexplored. This study comprehensively evaluated the effects of ERAS implementation on both postoperative recovery and psychological well-being in thyroid cancer surgery patients. This retrospective cohort study included 278 thyroid cancer patients undergoing thyroidectomy after 1:1 propensity score matching. Patients treated from January 2024 to December 2024 were managed according to the ERAS protocol (ERAS group, n = 139), while those treated from January 2023 to December 2023 received conventional perioperative care (control group, n = 139). The ERAS protocol comprised multimodal perioperative interventions including patient education, optimized anesthesia, early mobilization, and psychological support. Primary outcome was length of hospital stay. Secondary outcomes included early recovery metrics, pain scores (Visual Analog Scale), opioid consumption, hospitalization costs, psychological status (Self-rating Anxiety Scale, Self-rating Depression Scale), quality of life (36-Item Short Form Survey), and complications. The ERAS group demonstrated significantly shorter hospital stay and superior early recovery outcomes including earlier oral intake, mobilization, and drain removal (all P < .001). Pain scores were consistently lower at all postoperative timepoints, with reduced opioid consumption (P < .001). Total hospitalization costs were significantly reduced in the ERAS group (P < .001). ERAS patients showed significantly lower anxiety and depression scores throughout recovery (P < .001) and higher quality of life scores at discharge and 1 month postoperatively (P < .05). Total complication rates were reduced (23.74% vs 35.97%, P = .026), with significant decreases in transient hypocalcemia, postoperative nausea and vomiting, and hypothermia. ERAS implementation in thyroid cancer surgery is associated with improved postoperative recovery, reduced complications, decreased costs, and enhanced psychological well-being, supporting its adoption as a comprehensive perioperative care strategy addressing both physical and psychological dimensions of recovery.