Application of enhanced recovery after surgery in aged patients undergoing radical colorectal surgery

Abstract

Objective To evaluate the safety and efficacy of enhanced recovery after surgery (ERAS)combined with radical colorectal surgery for aged patients with colon cancer or rectal cancer. Methods From February 2015 to January 2017, the clinical data of one hundred and sixty patients undergoing radical colorectal cancer surgery combined with ERAS in Yantai Yuhuangding Hospital were collected. They were divided into two groups: the young group (< 65 years old, 97 cases) and the elderly group (≥65 years old, 63 cases). The recovery of gastrointestinal function, postoperative complications and the length of hospital stay between the two groups were compared. Results Compared with the young group, ASA score and the ratio of basic diseases of the elderly patients were higher (χ2=10.960, P=0.001). There was no significant difference in the type of operation, the mode of operation, the rate of postoperative complications and the incidence of serious complications between the two groups (χ2=0.171, 1.039, 0.296, 0.001, P=0.680, 0.595, 0.586, 0.979) . Non-operative complications, especially cardiovascular complications, were more common in the elderly patients. The incidence of reoperation and readmission were 6.2%, 5.2% in the young group, and 9.5%, 3.2% in the elderly group respectively, with no statistical differences (χ2=0.641, 0.041, P=0.433, 0.839) . In the elderly group, intestinal function recovery was slower, postoperative anal exhaust, postoperative anal defecation and hospitalization time were significantly longer than those in the young group (Z=1.89, 2.37, 3.11, P=0.034, 0.013, 0.001). Conclusion The combination of ERAS and radical colorectal surgery is safe and effective in aged patients with colon cancer or rectal cancer. Key words: Colorectal neoplasms; Enhanced recovery after surgery; Colorectal Surgery; Complication; Aged