Effects of the enhanced recovery after surgery (ERAS) protocol on the postoperative stress state and short‐term complications in elderly patients with colorectal cancer

Abstract

AbstractObjectiveThe aim of this study was to evaluate the feasibility and necessity of enhanced recovery after surgery in elderly patients with colorectal cancer by observing inflammatory markers and postoperative complications.MethodsHospitalized colorectal cancer patients from the Affiliated Hospital of Jiangsu University from January 2021 to September 2022 were included in the study and divided into two groups: Enhanced Recovery After Surgery (ERAS) and non‐ERAS. Data on postoperative inflammatory markers and complications were also collected.ResultsA total of 313 patients with colorectal cancer were included: 182 in the ERAS group and 131 in the non‐ERAS group. The patients in the ERAS group had significantly shorter days of postoperative hospitalization, urinary catheter and drainage tube withdrawal times, and recovery of bowel function (P < .05) than those of the non‐ERAS group. Moreover, the ERAS group had lower hospitalization expenses than those of the non‐ERAS group (P < .05). However, the procalcitonin and tumor necrosis factor (TNF)‐α levels in the ERAS group was significantly lower than those in the non‐ERAS group on postoperative days 1 and 3 (P < .05), and the interleukin (IL)‐6 and IL‐10 levels in the ERAS group were significantly lower than those in the non‐ERAS group on the 1st, 3rd, and 5th postoperative days (P < .05). The C‐reactive protein (CRP) and white blood cell (WBC) levels in the ERAS group were lower than those in the non‐ERAS group on postoperative days 3 and 5 (P < .05). However, the hemoglobin levels did not differ significantly (P > .05). The albumin levels did not differ significantly between the two groups before surgery (P > .05); however, the albumin level in the ERAS group was higher than that in the non‐ERAS group on postoperative days 3 and 5 (P < .05). The ERAS patients had lower albumin levels after surgery than those of the non‐ERAS patients (P < .05).ConclusionERAS leads to a series of perioperative optimization measures, thereby reducing the postoperative stress response in elderly patients with colorectal cancer and the occurrence of perioperative complications.