Modified enhanced recovery after surgery protocol in octogenarians undergoing minimally invasive colorectal cancer surgery.
J Am Geriatr Soc
; 72(9): 2679-2689, 2024 Sep.
Article
in En
| MEDLINE
| ID: mdl-38838363
ABSTRACT
BACKGROUND:
Colorectal cancer (CRC) is a major health issue worldwide. As the population ages, more older patients including octogenarians will require CRC treatment. However, this vulnerable group has decreased functional reserves and increased surgical risks. Enhanced recovery after surgery (ERAS) pathways aim to reduce surgical stress and complications, but concerns remain about applying ERAS protocols to older patients. We assessed whether a modified ERAS (mERAS) protocol combined would improve outcomes in octogenarian CRC patients undergoing minimally invasive surgery.METHODS:
In this retrospective cohort study, we compared 360 non-octogenarians aged 50-64 years and 114 octogenarians aged 80-89 years before and after mERAS protocol implementation. Outcomes including postoperative functionary recovery, length of stay, complications, emergency department visits, and readmissions were analyzed.RESULTS:
Despite comparable tumor characteristics, octogenarians had poorer nutrition, American Society of Anesthesiologists status, and more comorbidities. After mERAS, octogenarians had reduced complications, faster return of bowel function, and shorter postoperative length of stay, similar to non-octogenarians. mERAS implementation improved recovery in both groups without increasing emergency department visits or readmissions.CONCLUSION:
Although less remarkable than in non-octogenarians, mERAS protocols mitigated higher complication rates and improved recovery in octogenarians after minimally invasive surgery for CRC, confirming protocol feasibility and safety in this vulnerable population.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
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Colorectal Neoplasms
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Minimally Invasive Surgical Procedures
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Enhanced Recovery After Surgery
/
Length of Stay
Limits:
Aged80
/
Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
J Am Geriatr Soc
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: