Key result
Implementation of a standardized enhanced recovery protocol in elderly patients undergoing colorectal surgery significantly reduced median postoperative hospital stay from 11 to 6 days and improved overall short-term surgical outcomes.
Why the study?
Does a standardized enhanced recovery protocol improve short-term surgical results in elderly patients undergoing colorectal resections?
Cohort (n=745)
No
Does a standardized enhanced recovery protocol improve short-term surgical results in elderly patients undergoing colorectal resections?
Implementation of a standardized enhanced recovery protocol significantly improves short-term outcomes, including mortality and hospital stay, in elderly patients undergoing colorectal cancer surgery.
May support enhanced recovery in elderly colorectal surgery; hypothesis-generating and requires randomized confirmation before practice change.
AIM. To evaluate the influence of standardized enhanced recovery protocol on the results of oncological colorectal resections in elderly (≥75) patients. MATERIALS AND METHODS. We retrospectively analyzed the results of 745 colorectal resections, performed from March 2009 till Oct. 2016. During 2009-2013 (220 procedures, 45 among the elderly) only sporadic components of enhanced recovery were used. In 2014-2015 (354 surgeries, 82 among the elderly) new surgical team developed and started to implement a standardized enhanced recovery protocol. In 2016 (186 procedures, 51 among the elderly) the protocol was systematically used in every patient. Short-term surgical results were analyzed. RESULTS. Generally, implementation of enhanced recovery protocol led to mild but not statistically significant improvement of short-term results. Only postoperative hospital stay decreased significantly. However, we observed a dramatic improvement of short-term results after the implementation of enhanced recovery protocol among the elderly patients. CONCLUSION. Standardized evidence-based enhanced recovery protocol leads to significant improvement of short-term surgical results in elderly patients undergoing colorectal surgery for cancer.
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Lyadov et al. (2017) conducted a cohort in Colorectal cancer (n=745). Standardized enhanced recovery protocol (ERAS) vs. Sporadic use of enhanced recovery components (historical control) was evaluated on Median postoperative hospital stay in elderly patients (days). Implementation of a standardized enhanced recovery protocol in elderly patients undergoing colorectal surgery significantly reduced median postoperative hospital stay from 11 to 6 days and improved overall short-term surgical outcomes.
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