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Do older patients (> 80 years) also benefit from ERAS after colorectal resection? A safety and feasibility study

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Abstract

Background and aims

The aim of this study was to evaluate the safety and feasibility of a standard Enhanced Recovery After Surgery (ERAS) program following colorectal resection in a geriatric population, aged 80 years and older.

Methods

In this single-center before-after cohort study all patients aged 80 years and older were included after colorectal resection. Patients were divided in a pre-ERAS and an ERAS group, according to the type of perioperative care. Data were prospectively collected and analysed retrospectively. The primary outcome was short-term complication rate. Secondary outcome parameters were length of stay (LOS), 30-day mortality and readmission rate.

Results

Over 4 years, 219 patients were included. Of those, 151 underwent colonic and 68 rectal resection, following the ERAS protocol perioperatively in 45 and 21 cases. There were no differences in complication rate, 30-day mortality or readmission rate in the pre-ERAS versus ERAS groups. LOS after colonic resection was reduced by 2.5 days in the ERAS group (p = 0.020). Laparoscopy was found to be an independent variable of LOS (p < 0.001, p = 0.009) and complication rate (p = 0.011, p < 0.001) for colonic and rectal surgery respectively.

Discussion

A standard ERAS protocol is safe and feasible in older patients undergoing colorectal resection. Colon resection was related with shorter LOS without increasing morbidity, readmission rate nor 30-day mortality. No adverse outcome after rectal resection was found either. Laparoscopy was associated with lower complication rate and shorter LOS.

Conclusion

A laparoscopic approach within an ERAS protocol should be considered for colorectal resection in every patient regardless of age.

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Data availability

Data will not be deposited.

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Funding

No funding was received.

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Authors and Affiliations

  1. Department of Abdominal Surgery, University Hospital Gasthuisberg Leuven, Herestraat 49, 3000, Leuven, Belgium

    Katrien Boon, Gabriele Bislenghi, André D’Hoore & Albert M. Wolthuis

  2. Leuven, Belgium

    Nele Boon

Authors
  1. Katrien Boon
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  2. Gabriele Bislenghi
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  3. André D’Hoore
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  4. Nele Boon
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  5. Albert M. Wolthuis
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Contributions

Data analysis was performed by Nele Boon. The first draft of the manuscript was written by KB. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Katrien Boon.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Statement of human and animal rights

This study was performed in accordance with the ethical standards of the Research Ethics Committee of the University Hospitals Leuven. They work in accordance with the ICH-GCP principles (International Conference on Harmonisation Guidelines on Good Clinical Practice), with the most recent version of the Helsinki Declaration, and with applicable laws and regulations.

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Informed consent was not considered necessary because this study was based on the collection of data generated by clinical practice.

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Boon, K., Bislenghi, G., D’Hoore, A. et al. Do older patients (> 80 years) also benefit from ERAS after colorectal resection? A safety and feasibility study. Aging Clin Exp Res 33, 1345–1352 (2021). https://doi.org/10.1007/s40520-020-01655-4

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  • DOI: https://doi.org/10.1007/s40520-020-01655-4

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