STANDARDIZED ENHANCED RECOVERY PROTOCOL IMPROVES OUTCOMES AFTER COLORECTAL RESECTIONS IN ELDERLY PATIENTS
https://doi.org/10.33878/2073-7556-2017-0-3-40-44
Abstract
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.
About the Authors
V. K. Lyadov
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
A. V. Kochatkov
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
A. Z. Negardinov
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
References
1. Каприн, А.Д. Злокачественные образования в России в 2014 г. (заболеваемость и смертность). /Под ред. А.Д.Каприна, В.В.Старинского, Г.В.Петровой.// М.: МНИОИ им. П.А.Герцена -филиал ФГБУ «НМИРЦ» Минздрава России. -2016. - 250 с.
2. Лядов, В.К. Влияние стандартизированного алгоритма периоперационного ведения на результаты правосторонней гемиколэктомии у пациентов пожилого и старческого возраста. / В.К.Лядов, A.В.Кочатков, А.З.Негардинов // Онкологическая колопроктология. - 2016. - № 6 (2). - 24-28.
3. Шелыгин, Ю.А. Оптимизация периоперационного процесса у пациентов, перенесших резекцию ободочной кишки. / Ю.А.Шелыгин, С.И.Ачкасов, И.В.Лукашевич // Хирургия. - 2015. - № 4. -с. 76-81.
4. Biondi, A. Role of surgery for colorectal cancer in the elderly. / A.Biondi, M.Vacante, I.Ambrosino et al. // World J. Gastrointest. Surg. - 2016; 8 (9): 606-613.
5. Kehlet, H. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme. / H.Kehlet, T.Mogensen // Br. J. Surg. -1999; 86 (2): 227-30.
6. Lassen, K. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. / K.Lassen, M.Soop, J.Nygren et al. // Arch. Surg. - 2009; 144 (10): 961-9.
7. Levy, B.F. 23-hour-stay laparoscopic colectomy. / B.F.Levy, M.J.Scott, W.J.Fawcett et al. // Dis. Colon Rectum. - 2009; 52 (7): 1239-43.
8. Odermatt, M. Major postoperative complications following elective resections for colorectal cancer decrease long-term survival but not the time to recurrence. / M.Odermatt, D.Miskovic, K.Flashman et al. // Colorectal Dis. - 2015; 17 (2): 141-9.
9. Slieker, J. Enhanced recovery ERAS for elderly: a safe and beneficial pathway in colorectal surgery. / J.Slieker, P.Frauche, J.Jurt et al. // Int. J. Colorectal. Dis. - 2017; 32 (2): 215-221
Review
For citations:
Lyadov V.K., Kochatkov A.V., Negardinov A.Z. STANDARDIZED ENHANCED RECOVERY PROTOCOL IMPROVES OUTCOMES AFTER COLORECTAL RESECTIONS IN ELDERLY PATIENTS. Koloproktologia. 2017;(3):40-44. (In Russ.) https://doi.org/10.33878/2073-7556-2017-0-3-40-44
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