BACKGROUND:The aim of this study was to investigate the feasibility and safety of an enhanced recovery programme (ERP) in patients aged ≥75 years who undergo laparoscopic surgery for colorectal cancer. METHODS:Patients were divided into two groups according to perioperative management: the ERP group (Group A, n = 94) and the conventional perioperative care group (Group B, n = 157). The postoperative outcomes were compared between two groups. RESULTS:There were no differences in terms of age, gender, American Society of Anesthesiologists score, operative time or blood loss between two groups. Postoperative return of gastrointestinal function was significantly faster in Group A compared to Group B, including time to first flatus (2 versus 3 days, P < 0.001), first stool (3 versus 4 days, P = 0.001) and oral intake (1 versus 4 days, P < 0.001). Group A was associated with lower overall postoperative complication rate (26.6% versus 44.6%, P = 0.004) and general complication rate (14.9% versus 31.2%, P = 0.004). The median postoperative hospital stay was 6 days in Group A and 8 days in Group B (P < 0.001), respectively. CONCLUSIONS:ERP following laparoscopic colorectal resection for elderly patients is associated with faster postoperative recovery, shorter postoperative hospital stay and fewer complications compared with conventional perioperative care.

译文

摘要背景:这项研究的目的是研究对接受腹腔镜手术治疗结直肠癌的≥75岁患者进行增强恢复计划(ERP)的可行性和安全性。
方法:根据围手术期管理将患者分为两组:ERP组(A组,n = 94)和常规围手术期护理组(B组,n = 157)。比较两组的术后结果。
结果:两组在年龄,性别,美国麻醉医师学会评分,手术时间或失血方面均无差异。与B组相比,A组的术后胃肠功能恢复明显更快,包括第一次肠胃胀气的时间(2天比3天,P <0.001),第一次大便时间(3天比4天,P = 0.001)和口服摄入量(1天对1天)。 4天,P <0.001)。 A组的总体术后并发症发生率较低(26.6%对44.6%,P = 0.004)和一般并发症发生率(14.9%对31.2%,P = 0.004)。 A组术后中位住院时间分别为6天和B组8天(P <0.001)。
结论:与常规围手术期护理相比,老年患者腹腔镜大肠切除术后的ERP与术后恢复更快,术后住院时间短和并发症少相关。

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