Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2018, Vol. 40 ›› Issue (6): 730-735.doi: 10.3881/j.issn.1000-503X.10622

• Original Articles • Previous Articles     Next Articles

Feasibility and Safety of Enhanced Recovery after Surgery for Elderly Patients with Colorectal Cancer

YU Junhui1,2,LI Xinbao1,WANG Dong2,YAO Hongwei2,JIN Lan2,YANG Yingchi2,LI Yan1()   

  1. 1Department of Peritoneal Cancer Surgery,Beijing Shijitan Hospital, Capital Medical University,Beijing 100038,China
    2Department of General Surgery,Beijing Friendship Hospital,Capital Medical University, National Clinical Research Center of Digestive Disease,Beijing 100050,China
  • Received:2018-06-06 Online:2018-12-20 Published:2019-01-03
  • Supported by:
    Supported by Beijing Municipal Administration of Hospital Ascent Plan(DFL20180701);Special Fund for the Capital Characteristic Clinical Medicine Development Project(Z161100000516077);Beijing Municipal Grant for Medical Talents Group(2017400003235J007);Key Discipline Development Fund of Beijing Shijitan Hospital Affiliated to the Capital Medical University(2016fmzlwk);Beijing Natural Sciences Foundation(7172108)

Abstract:

Objective To evaluate the feasibility and safety of enhanced recovery after surgery (ERAS) in elderly patients with colorectal cancer (CRC).
Methods A retrospective analysis was conducted on 230 CRC patients undergoing ERAS from January 2017 to January 2018. These subjects included 120 young patients (<70 years) and 110 elderly patients (≥70 years).The rates of ERAS compliance,anastomotic leakage,re-operation,and re-hospitalization,the mortality,and the average hospital stay were compared between these two groups.
Results The elderly group had significantly higher incidences including diabetes (20.9% vs. 10.8%,P=0.045),heart disease (24.5% vs. 11.7%,P=0.039),respiratory diseases (20.0% vs. 10.0%,P=0.041),and hypertension (26.4% vs. 15.0%,P=0.035) than the young group. However,these two groups were not statistically significant in terms of ERAS compliance rate (79% in the young group vs. 74% in the elderly group,P=0.574),incidence of anastomotic leakage (2.5% vs. 1.8%,P=1.000),re-operation rate (1.7% vs. 2.7%,P=0.672),re-hospitalization rate (2.5% vs. 4.5%,P=0.484),mortality rate within 30 days after operation (1.7% vs. 2.7%,P=0.672). The average hospital stay was 5 days in the young group and 7 days in the elderly group (P=0.000).
Conclusions Although the elderly patients tend to have poor general status,their ERAS compliance rate and main treatment indicators including incidence of anastomotic leakage,re-operation rate,re-hospitalization rate,and mortality rate within 30 days after surgery are not different from young patients. Thus,the ERAS program is safe and feasible for elderly CRC patients.

Key words: enhanced recovery after surgery, colorectal cancer, postoperative complications, postoperative average hospital stay

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