• Vol. 48 No. 11
  • 15 November 2019

Outcome of Enhanced Recovery After Surgery (ERAS) for Colorectal Surgery in Early Elderly and Late Elderly Patients

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ABSTRACT

This study aimed to determine the outcome of enhanced recovery after surgery (ERAS) programme in elderly colorectal surgery patients. Materials and Methods: Details and surgical outcomes of elderly patients undergoing elective colectomy and/or proctectomy according to ERAS protocol from 2011 to 2017 were retrospectively reviewed. Patients were divided into 2 groups: early elderly (EE, n = 107) aged 65–74 years old and late elderly (LE, n = 74) aged ≥75 years old. Results: This study included 181 patients. The LE group had poorer baseline characteristics, but the operative details in both groups were comparable. Overall complication and severe complication rates were 28% and 3.3%, respectively. The LE group had a higher overall complication rate (38% vs 22%; P = 0.016) but comparable rate of severe complications (2.7% vs 3.7%; P = 1.00). Median postoperative stay was 4 days (interquartile range [IQR], 4–6 days) and it was not significantly different between both groups (5 days for LE vs 4 days for EE; P = 0.176). No difference was seen in time to gastrointestinal recovery and 30-day mortality or readmission between both groups. Overall compliance with ERAS protocol was 76% (IQR, 65–82%) and it did not vary significantly between the LE (71%) and EE (76%) groups (P = 0.301). However, the LE group had lower compliance with fluid management, nutrition therapy and use of multimodal analgesia. Conclusion: ERAS is a safe and effective protocol that can be used in EE and LE colorectal surgery patients.


Individuals ≥65 years old are termed elderly. In the
literature, a distinction is made between those aged 65–74
years, described as “early elderly” (EE), and those aged ≥75
years, known as “late elderly” (LE). In surgical practice,
there is evidence that advanced age is an important risk factor
for postoperative morbidity and mortality.

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