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Updates in Surgery

, Volume 70, Issue 1, pp 7–13 | Cite as

Enhanced recovery pathway in elderly patients undergoing colorectal surgery: is there an effect of increasing ages? Results from the perioperative Italian Society Registry

  • Marco Braga
  • Luigi Beretta
  • Nicolò Pecorelli
  • Marianna Maspero
  • Umberto Casiraghi
  • Felice Borghi
  • Luca Pellegrino
  • Stefano Bona
  • Roberta Monzani
  • Gianluigi Ferrari
  • Danilo Radrizzani
  • Riccardo Iuliani
  • Carlo Bima
  • Marco Scatizzi
  • Giancarlo Missana
  • Marco Azzola Guicciardi
  • Andrea Muratore
  • Michele Crespi
  • Hedayat Bouzari
  • Andrea Pisani Ceretti
  • Ferdinando Ficari
  • On behalf of PeriOperative Italian Society Group
Original Article

Abstract

Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed. 315 elderly patients undergoing elective colorectal resection were divided into three groups. Group 1: 71–75 years (n = 105), Group 2: 76–80 years (n = 117), Group 3: over 80 years (n = 93). Primary endpoints of the study were adherence to ERP and time to readiness for discharge (TRD). Compliance to ERP was similar in the three groups. No difference among groups was found for mortality, overall morbidity, major complications, reoperation rate and readmission rate. Median TRD and length of hospital stay (LOS) were progressively longer with increasing age (p = 0.018 and p = 0.078, respectively). Increasing age did not impact on adherence to ERP and postoperative morbidity, but delayed both TRD and LOS.

Keywords

Enhanced recovery after surgery Colorectal surgery Elderly Postoperative morbidity Length of stay 

Notes

Compliance with ethical standards

Funding

None.

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This research involves only human participants. This retrospective study is in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

All patients signed an informed consent form before surgery.

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Copyright information

© Italian Society of Surgery (SIC) 2017

Authors and Affiliations

  • Marco Braga
    • 1
  • Luigi Beretta
    • 2
  • Nicolò Pecorelli
    • 1
  • Marianna Maspero
    • 1
  • Umberto Casiraghi
    • 1
  • Felice Borghi
    • 3
  • Luca Pellegrino
    • 3
  • Stefano Bona
    • 4
  • Roberta Monzani
    • 5
  • Gianluigi Ferrari
    • 6
  • Danilo Radrizzani
    • 7
  • Riccardo Iuliani
    • 8
  • Carlo Bima
    • 8
  • Marco Scatizzi
    • 9
  • Giancarlo Missana
    • 10
  • Marco Azzola Guicciardi
    • 11
  • Andrea Muratore
    • 12
  • Michele Crespi
    • 13
  • Hedayat Bouzari
    • 14
  • Andrea Pisani Ceretti
    • 15
  • Ferdinando Ficari
    • 16
  • On behalf of PeriOperative Italian Society Group
  1. 1.Department of Surgery, San Raffaele HospitalVita-Salute UniversityMilanItaly
  2. 2.Department of Anesthesiology, San Raffaele HospitalVita-Salute UniversityMilanItaly
  3. 3.Department of SurgeryCuneo HospitalChicagoUSA
  4. 4.Department of SurgeryHumanitas Hospital MilanMilanItaly
  5. 5.Department of AnesthesiologyHumanitas Hospital MilanMilanItaly
  6. 6.Department of SurgeryLegnano HospitalLegnanoItaly
  7. 7.Department of AnesthesiologyLegnano HospitalLegnanoItaly
  8. 8.Department of SurgeryCottolengo Hospital TurinTurinItaly
  9. 9.Department of SurgeryPrato HospitalPratoItaly
  10. 10.Department of SurgeryCasa di Cura Città di UdineUdineItaly
  11. 11.Department of SurgeryCantù HospitalCantùItaly
  12. 12.Department of SurgeryCandiolo HospitalTurinItaly
  13. 13.Department of SurgeryLuigi Sacco HospitalMilanItaly
  14. 14.Department of SurgeryMauriziano Hospital TurinTurinItaly
  15. 15.Department of SurgerySan Paolo HospitalSão PauloBrazil
  16. 16.Department of Surgery, Careggi HospitalUniversity of FlorenceFlorenceItaly

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