SYSTEMATIC REVIEW article
Front. Surg.
Sec. Visceral Surgery
This article is part of the Research TopicEnhanced Recovery After Gastrointestinal SurgeryView all articles
Perioperative Neurocognitive Disorder in Colorectal Cancer Surgery: A Systematic Review of Incidence, Mechanisms, and Interventions
Provisionally accepted
- 1Chengdu Second People's Hospital, Chengdu, China
- 2North Sichuan Medical College, Nanchong, China
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Abstract Background: Perioperative neurocognitive disorder (PND) represents a significant impediment to postoperative recovery in patients undergoing colorectal cancer surgery, particularly among the elderly. This systematic review synthesizes contemporary evidence on PND incidence, risk stratification, and prophylactic strategies. Methods: Adhering to PRISMA guidelines, 343 records were identified from PubMed, Embase, and Web of Science. Bibliometric profiling delineated influential journals, institutions, and seminal references. Following deduplication and screening, 11 randomized controlled trials (RCTs) met inclusion criteria for systematic analysis. Results: Bibliometric analysis revealed Journal of Geriatric Oncology (impact factor 2.7) and Amphia Hospital (Netherlands) as top contributors. PND incidence ranged from 3.4% to 56% across studies. Key risk factors included advanced age (mean 63–76 years), ASA status II-III, and open surgery. Prophylactic interventions reduced PND: melatonin decreased POD by 20%; dexmedetomidine reduced PND by 10.8–25%. Fast-track surgery lowered POD by 9.5%. Mechanistically, effective strategies attenuated neuroinflammation (IL-6/TNF-α reduction) and optimized analgesia. Conclusions: Multimodal interventions—especially dexmedetomidine-enhanced analgesia and fast-track protocols—consistently mitigate PND. Standardization of PND assessment tools and diversification of study populations are urgently needed.
Keywords: Perioperative neurocognitive disorder, postoperative delirium, postoperative cognitive dysfunction, Colorectal cancer surgery, Systematic review
Received: 04 Sep 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Bu, Quan, Huang, Zhan and Bhushan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jun Bu, bujunjoy@yeah.net
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