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Cited 39 time in webofscience Cited 44 time in scopus
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The safety of a "fast-track" program after laparoscopic colorectal surgery is comparable in older patients as in younger patients

Authors
Baek, Se-JinKim, Seon-HahnKim, Se-YoungShin, Jae-WonKwak, Jung-MyunKim, Jin
Issue Date
Apr-2013
Publisher
SPRINGER
Keywords
Fast-track; Enhanced recovery after surgery (ERAS); Aged patients; Colorectal surgery; Laparoscopy
Citation
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, v.27, no.4, pp.1225 - 1232
Indexed
SCIE
SCOPUS
Journal Title
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
Volume
27
Number
4
Start Page
1225
End Page
1232
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/10833
DOI
10.1007/s00464-012-2579-7
ISSN
0930-2794
Abstract
Fast-track protocols, introduced in the late 1990s, have been applied in several surgical fields, particularly for colorectal surgery. However, currently many surgical patients are elderly, and discussion about the application of such programs for elderly patients is lacking. The present study was designed to assess the safety of application of a fast-track program after laparoscopic colorectal surgery in elderly patients. From August 2009 to January 2011, we prospectively collected data from patients who underwent laparoscopic colorectal surgery with a perioperative fast-track program. The data of patients older and younger than 70 years were compared. Of a total of 337 patients, the group of patients older than 70 years (OG) totaled 87 (25.8 %) and the younger group (YG) totaled 250 (74.2 %). Ten patients (11.5 %) were excluded in the OG and 24 (9.6 %) in the YG. There were no differences in gender, history of previous surgeries, body mass index, type of operation, operative time, or blood loss between groups. Age (74.8 vs. 56.7 years, p < 0.001), presence of comorbidities (70.1 vs. 44.7 %, p < 0.001), and ASA score (I:II:III, 33.8:57.1:9.1 vs. 60.6:33.2:6.2 %, p < 0.001) were significantly different between the two groups. Postoperative course did not show differences, including return of flatus, stool passage, advancement of diet, removal of urinary catheter, length of usage of IV antibiotics, complications, and length of postoperative stay. Emergency department visits or readmission within a month after discharge were more frequent in the OG (11.7 %) than the YG (4 %; p = 0.013). Fast-track after laparoscopic colorectal surgery can be safely applied in carefully selected elderly patients older than age 70 years. Physicians should keep in mind complications that may present after discharge and should actively educate patients about them.
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Kim, Jin
Anam Hospital (Department of Colon and Rectal Surgery, Anam Hospital)
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