Do older patients (> 80 years) also benefit from ERAS after colorectal resection? A safety and feasibility study.
Colorectal resection
ERAS
Elderly
Feasibility
Laparoscopy
Safety
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
28
04
2020
accepted:
10
07
2020
pubmed:
29
7
2020
medline:
1
5
2021
entrez:
29
7
2020
Statut:
ppublish
Résumé
The aim of this study was to evaluate the safety and feasibility of a standard Enhanced Recovery After Surgery (ERAS) program following colorectal resection in a geriatric population, aged 80 years and older. In this single-center before-after cohort study all patients aged 80 years and older were included after colorectal resection. Patients were divided in a pre-ERAS and an ERAS group, according to the type of perioperative care. Data were prospectively collected and analysed retrospectively. The primary outcome was short-term complication rate. Secondary outcome parameters were length of stay (LOS), 30-day mortality and readmission rate. Over 4 years, 219 patients were included. Of those, 151 underwent colonic and 68 rectal resection, following the ERAS protocol perioperatively in 45 and 21 cases. There were no differences in complication rate, 30-day mortality or readmission rate in the pre-ERAS versus ERAS groups. LOS after colonic resection was reduced by 2.5 days in the ERAS group (p = 0.020). Laparoscopy was found to be an independent variable of LOS (p < 0.001, p = 0.009) and complication rate (p = 0.011, p < 0.001) for colonic and rectal surgery respectively. A standard ERAS protocol is safe and feasible in older patients undergoing colorectal resection. Colon resection was related with shorter LOS without increasing morbidity, readmission rate nor 30-day mortality. No adverse outcome after rectal resection was found either. Laparoscopy was associated with lower complication rate and shorter LOS. A laparoscopic approach within an ERAS protocol should be considered for colorectal resection in every patient regardless of age.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
The aim of this study was to evaluate the safety and feasibility of a standard Enhanced Recovery After Surgery (ERAS) program following colorectal resection in a geriatric population, aged 80 years and older.
METHODS
METHODS
In this single-center before-after cohort study all patients aged 80 years and older were included after colorectal resection. Patients were divided in a pre-ERAS and an ERAS group, according to the type of perioperative care. Data were prospectively collected and analysed retrospectively. The primary outcome was short-term complication rate. Secondary outcome parameters were length of stay (LOS), 30-day mortality and readmission rate.
RESULTS
RESULTS
Over 4 years, 219 patients were included. Of those, 151 underwent colonic and 68 rectal resection, following the ERAS protocol perioperatively in 45 and 21 cases. There were no differences in complication rate, 30-day mortality or readmission rate in the pre-ERAS versus ERAS groups. LOS after colonic resection was reduced by 2.5 days in the ERAS group (p = 0.020). Laparoscopy was found to be an independent variable of LOS (p < 0.001, p = 0.009) and complication rate (p = 0.011, p < 0.001) for colonic and rectal surgery respectively.
DISCUSSION
CONCLUSIONS
A standard ERAS protocol is safe and feasible in older patients undergoing colorectal resection. Colon resection was related with shorter LOS without increasing morbidity, readmission rate nor 30-day mortality. No adverse outcome after rectal resection was found either. Laparoscopy was associated with lower complication rate and shorter LOS.
CONCLUSION
CONCLUSIONS
A laparoscopic approach within an ERAS protocol should be considered for colorectal resection in every patient regardless of age.
Identifiants
pubmed: 32720244
doi: 10.1007/s40520-020-01655-4
pii: 10.1007/s40520-020-01655-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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