Short-Term Outcomes of Colorectal Resection for Cancer in Elderly in the Era of Enhanced Recovery

TitreShort-Term Outcomes of Colorectal Resection for Cancer in Elderly in the Era of Enhanced Recovery
Type de publicationArticle de revue
AuteurVenara, Aurélien , Barbieux, Julien, Mucci, Stéphanie, Talbot, M F, Lermite, Emilie, Hamy, Antoine
EditeurSAGE Publications
TypeArticle scientifique dans une revue à comité de lecture
DateMars 2018
Titre de la revueScandinavian journal of surgery
Mots-clésAged, Aged, 80 and over, Cohort Studies, Colectomy, Colorectal Neoplasms, Disease-Free Survival, Early Ambulation, Elective Surgical Procedures, Emergency Treatment, Feasibility Studies, Female, Follow-Up Studies, France, Geriatric Assessment, Hospitals, University, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasm Invasiveness, Neoplasm Staging, Postoperative Care, Postoperative Complications, Prospective Studies, Recovery of Function, Risk Assessment, Survival Analysis, Time Factors
Résumé en anglais

BACKGROUND AND AIMS: Early rehabilitation protocols should be assessed in elderly. We aimed to study the outcomes of colorectal surgery and the observance of the modalities of an early rehabilitation protocol in patients over 80 years.

MATERIAL AND METHODS: All consecutive patients who underwent surgery for colorectal cancer in our center over a 19-month period were included. All of these patients were managed using the same early rehabilitation protocol. Patients older than 80 were compared to younger patients.

RESULTS: A total of 173 patients were included and 36 were ≥80 years (20.8%). Patients aged ≥80 years had a significantly higher ASA score and were operated on in emergency. In the peroperative period, patients aged ≥80 years were more likely to undergo laparotomy than patients <80 years in univariate analysis (p = 0.048), but in multivariate analysis, the choice for a laparoscopy was influenced by ASA score ≤2 (odds ratio = 3.55, 95% confidence interval = 1.67-7.58) and emergency surgery (odds ratio = 0.18, 95% confidence interval = 0.06-0.50). In the postoperative period, peristalsis stimulation and vascular catheter ablation were significantly better followed in Group 1 (p = 0.012 and 0.031). However, in multivariate analysis, age was not significantly associated with these parameters. Peristalsis stimulation was influenced by ASA score ≥2 (odds ratio = 4.27, 95% confidence interval = 1.18-15.37) and vascular catheter ablation was also influenced by ASA score ≤2 (odds ratio = 2.63, 95% confidence interval = 1.33-5.21). Emergency surgery had a strong trend to influence these parameters (p = 0.08).

CONCLUSION: Although age or comorbidities may affect observance for certain modalities such as chewing gum use and vascular catheter ablation, an early rehabilitation protocol can be used after colorectal cancer surgery in patients ≥80 years old, where it would improve functional results and postoperative outcomes.

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Autre titreScand J Surg
Identifiant (ID) PubMed28464708