Influence of alexithymia and negative affectivity on early postoperative outcomes after colorectal surgery within an enhanced recovery after surgery program

Background and objectives Personality traits and emotional domains have been hypothesised to influence surgery outcomes. This cross-sectional study explored associations between alexithymia and negative affectivity and early postoperative outcomes following colorectal resection. Methods From a cohort of patients who underwent laparoscopic colorectal surgery at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust between March 2015 and November 2021, 146 patients completed the “Toronto Alexithymia Scale 20 items” (TAS-20) and the “Type-D Scale” (DS14) during a postoperative interview. Clinicopathological data and postoperative outcomes were prospectively collected. Statistical analysis included regression models using the TAS-20 and DS14 negative affectivity subscale as explanatory variables, adjusting for sociodemographic factors and correcting for multiple testing according to Benjamini-Hochberg. Results Of the 146 patients, 43.1% met criteria for alexithymia, while 43.2% met criteria for negative affectivity. An association was found between negative affectivity and increased odds of postoperative complications (OR 4.42; p = 0.002) and need for analgesic intervention after the third postoperative day (OR 3.79; p = 0.015). Higher levels of alexithymia were associated with longer time to achieve a numeric pain rating scale score < 4 (β 0.062; p = 0.038) on a scale going from 0 to 10. Conclusions In this cross-sectional study alexithymia and negative affectivity were associated with selected early unfavourable postoperative outcomes. While these results may have implications for improving quality of life of individuals undergoing major surgery, they require confirmation in larger prospective studies that include preoperative psychological assessment.