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Article dans une revue

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

Abstract :

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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https://hal.univ-angers.fr/hal-02648424
Contributeur : Okina Université d'Angers <>
Soumis le : vendredi 29 mai 2020 - 09:33:47
Dernière modification le : mercredi 14 octobre 2020 - 04:16:56

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Stéphanie Mucci, M Talbot, Emilie Lermite, Antoine Hamy, Aurélien Venara, et al.. Short-Term Outcomes of Colorectal Resection for Cancer in Elderly in the Era of Enhanced Recovery. Scandinavian journal of surgery, 2018, 107, pp.31-37. ⟨10.1177/1457496917706010⟩. ⟨hal-02648424⟩

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