Enhanced recovery care after colorectal surgery in elderly patients. Compliance and outcomes of a multicenter study from the Spanish working group on ERAS.

Enhanced recovery care after colorectal surgery in elderly patients. Compliance and outcomes of a multicenter study from the Spanish working group on ERAS.

Gonzalez-Ayora S, Pastor C, Guadalajara H, Ramirez JM, Royo P, Redondo E, Arroyo A, Moya P, Garcia-Olmo D. Int J Colorectal Dis. 2016 Sep;31(9):1625-31. doi: 10.1007/s00384-016-2621-7. Epub 2016 Jul 4.

What is already known:
The benefits of ERAS for patients undergoing colorectal surgery is well known. However, the benefits to specific patient groups in particular the elderly, is less well known.

What this paper adds:
This is a multicentre non-randomised retrospective analysis of patients over 70 years old undergoing colon or rectal surgery in three Spanish tertiary hospitals. Their ERAS programme comprised ten main elements. 188 patients over 70 underwent surgery [median 79 (70-93)]. Global compliance of the elements was a less than impressive 56% overall. Only 44% of patients underwent laparoscopic surgery; 43% of patients did not have an abdominal drain; only 64% had their urinary catheter removed promptly and 67% had epidural analgesia. However, 90% of patients underwent early mobilisation and early intake of clear fluids. Overall length of stay was 6 days. The authors found that with increasing compliance length of stay decreased, and importantly only 6.4% of patients were readmitted to hospital after discharge. The study showed that ERAS after colorectal surgery is safe and feasible, and that age is no barrier to an effective programme.

Chris Jones, Guildford. @chrisnjones