Abstract
ObjectiveTo Explore the perioperative application of enhanced recovery after surgery (ERAS) and negative-pressure wound therapy in the elderly patients with colorectal cancer.MethodsA retrospective clinical data were studied in the patients with colorectal cancer in Department of General Surgery in Shanghai Fourth People,s Hospital (from March, 2017 to March, 2019), One hundred and fifty patients with undergoing radical surgery for colorectal cancer were divided into two groups: ERAS group (n = 76 cases, accepting ERAS management) and Conventional treatment(CT) group (n = 74 cases, accepting traditional treatment), Bleeding in operation, the time of postoperative anal flatus, number of wound dressing changing, time of wound healing, the length of postoperative hospital stay, readmission rate, postoperative complication, were compared between the two groups.ResultsERAS was associated with less bleeding in operation, less Wound fat liquefaction, less wound dressing changing, less time of wound healing, less time of postoperative anal flatus compare to CT group (P < 0.05); anastomotic fistula, readmission rate is similar in two groups (P > 0.05).ConclusionThe modified ERAS can be safely applied to the perioperative period of elderly colorectal cancer patients and promote recovery; negative-pressure wound therapy is helpful for wound healing and promoting rehabilitation.
Highlights
An increasing number of elderly patients is subjected to colorectal surgery
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Right colon and flexure Transverse colon Left colon and left flexure Rectum Sigmoid Scope of surgery Right hemicolectomy Left hemicolectomy Anterior/Low anterior resection Abdominoperineal resection Radical resection of sigmoid carcinoma Other operations Preoperative Comorbidities Preoperative anemia Preoperative hypoproteinemia Coronary heart disease Diabetes mellitus Hypertensive disease Cerebral infarction Preoperative nutritional support age, no surgical contraindications。exclusion criteria: Heart, lung, liver and kidney severe dysfunction; The basic data of the two groups are shown in Table 1, Most of the patients in both groups had different degrees of hypertensive, diabetic and heart diseases, There was no significant difference between the two groups in gender, age and surgical methods
Summary
An increasing number of elderly patients is subjected to colorectal surgery. In the past 30 years, the incidence of colorectal cancer in China has been increasing year by year, especially in economically developed areas. In 1962, colorectal cancer was only the 7th most common malignant tumor in Shanghai, but in 2003, it has become the second most common malignant tumor. From 1988 to 1992, the incidence of colorectal cancer was 27.0 per 100,000 males and 26.6 per 100,000 females. In 1997, the incidence of colorectal cancer was 37.2 per 100,000 males and 36.5 per 100,000 females respectively. In 2003, 51.2% of the patients with colorectal cancer in Shanghai urban area were > 70 years old. With the continuous emergence of aging city, colorectal cancer in the elderly will become a key research topic
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