STANDARDIZED ENHANCED RECOVERY PROTOCOL IMPROVES OUTCOMES AFTER COLORECTAL RESECTIONS IN ELDERLY PATIENTS

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.