The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
Major colorectal cancer resection should not be denied to the elderly.
AIMS Adjuvant therapy after surgery for colorectal cancer is often denied to the elderly for various reasons . This study was to determine morbidity and mortality risk after surgery in the elderly and whether this is affected by adjuvant therapy . METHODS Data were collected prospect ively and entered on a data base for all patients undergoing resection of colorectal cancer between January 1994 and July 2000 . A total of 304 patients were included , 65 aged 80 years and over . RESULTS There were 84 deaths , 21 ( 30 % ) in the over 80s , and 63 ( 26 % ) in the under 80s ( P=0.51 ) . The ' in-hospital ' mortality was 10.1 % in the over 80s and 3.8 % in the under 80s ( P=0.056 ) . In the over 80s the colon was more affected than the rectum ( P=0.002 ) . The over 80s were less likely to be offered  adjuvant therapy  , 7.2 % vs 42.1 % ( P<0.001 ) . The 5 year survival ( all-cause mortality ) in the over 80s was 58.5 % and 47.6 % in the under 80s ( P=0.25 ) . Cox 's regression analysis of all patients identified the following factors to be independently related to overall survival : age>80 years , post-operative leak , increasing Dukes stage and distant recurrence of disease . CONCLUSION This study has demonstrated that surgery should not be denied to elderly patients with colorectal cancer as despite a higher post-operative morbidity and mortality rate and with the absence of adjuvant therapy , favourable long-term outcome can be achieved by resectional surgery alone
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .