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World J Gastrointest Surg. Nov 27, 2026; 18(11): 119120
Published online Nov 27, 2026. doi: 10.4240/wjgs.119120
Published online Nov 27, 2026. doi: 10.4240/wjgs.119120
Preoperative depression as a neuroimmune-cholinergic vulnerability state for postoperative cognitive dysfunction after gastrointestinal cancer surgery
Gang Wang, Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
Sheng-Jie Pan, Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
Co-corresponding authors: Gang Wang and Sheng-Jie Pan.
Author contributions: Wang G contributed to project administration, validation, resources, and writing - review and editing; Wang G and Pan SJ contributed to conceptualization, read and approved the final manuscript and agree to be accountable for all aspects of the work, and they contributed equally to this manuscript and are co-corresponding authors; Pan SJ contributed to methodology, investigation, data curation, formal analysis, writing - original draft, supervision, and visualization.
AI contribution statement: AI-assisted tools, such as Grammarly and DeepL, were employed solely for language polishing, including improving grammar, clarity, and readability. These tools did not generate any scientific content. The entirety of the manuscript’s scientific content-including the abstract, introduction, materials and methods, results, discussion, and conclusion - was fully authored by the human authors. No text was AI-generated or AI-paraphrased. AI tools did not participate in study conceptualization, experimental design, data analysis, interpretation of results, or conclusions. All figures, tables, and graphical content were independently created by the authors without any AI assistance. In summary, AI tools were strictly used to refine language for clarity and readability. They did not influence the scientific content, analyses, or conclusions of the manuscript in any manner.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Gang Wang, MD, PhD, Professor, Department of General Surgery, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou 215006, Jiangsu Province, China. 286651551@qq.com
Received: January 20, 2026
Revised: January 30, 2026
Accepted: March 2, 2026
Published online: November 27, 2026
Processing time: 296 Days and 21.6 Hours
Revised: January 30, 2026
Accepted: March 2, 2026
Published online: November 27, 2026
Processing time: 296 Days and 21.6 Hours
Core Tip
Core Tip: Postoperative cognitive dysfunction (POCD) is a frequent yet underappreciated complication in elderly patients undergoing gastrointestinal tumor surgery. This editorial highlight emerging evidence that preoperative depression represents a biologically active vulnerability state that predisposes patients to POCD through synergistic neuroinflammatory activation and cholinergic dysfunction. By integrating findings on interleukin-6-mediated inflammation and impaired cholinergic regulation, the article reframes POCD as a disorder of perioperative brain resilience. This perspective supports earlier risk identification and mechanism-based preventive strategies to preserve cognitive health in aging surgical populations.