P21 FEASIBILITY OF ENHANCED RECOVERY PROTOCOL AFTER ESOPHAGEAL SURGERY IN ELDERLY PATIENTS. (23rd November 2019)

• Record Type: Journal Article
• Authors: De Pasqual, C A; Weindelmayer, J; La Mendola, R; Alberti, L; Ridolfi, C; Gervasi, M C; Giacopuzzi, S; de Manzoni, G
• Is Part Of: Diseases of the esophagus. Volume 32(2019)Supplement 2
• Publication Date: 2019-11-23
• Subjects: Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doz092.21
• Languages: English
• ISSNs: 1120-8694

Abstract

Abstract: Background: In dedicated centres ERAS (Enhanced Recovery After Surgery) programs have been successfully applied after esophageal surgery. However, some concerns have been raised about the feasibility of these protocols in elderly patients. Methods: We retrospective reviewed 72 patients submitted to Ivor-Lewis esophagectomy in our Institution, during the period 2015-2017. We divided the patients into two groups: 47 patients (65, 3%) were <70 years old (Young Group, YG) while 25 patients (34, 7%) were ≥70 years old (Elderly Group, EG). We compared post-operative outcomes and adherence to ERAS steps of the two groups. Results: The two groups were not different in terms of overall morbidity rate (53, 2% in YG vs 60, 0% in EG p= 0, 6) and pulmonary complications rate (70, 2% in YG vs 72, 0% in EG, p= 1). EG showed a higher cardiac complications rate (3, 5% in YG vs 26, 7% in EG, p=0, 001). We did not report 90-days mortality. We did not observe differences in adherence to the following ERAS steps: pre-operative carbohydrate load administration (78, 7% in YG vs 76, 0% in EG, p=0, 7), ward transfer on POD 0 (61, 7% in YG vs 48, 0% in EG, p=0, 32), removal of naso-gastric tube on POD 1 (87, 2% in YG vs 96, 0% in EG, p=0, 4), resume of liquid diet on POD 1 (55, 3% in YG vs 56, 0% in EG, p=1), urinary catheter removal on POD 2 (61, 7% in YG vs 48, 0% in EG, p=0, 3), fully mobilization on POD 3 (63, 8% in YG vs 52, 0% in EG, p=0, 4), resume of soft diet on POD 4 (72, 3% in YG vs 68, 0% in EG, p=0, 7), discharge on POD 7 (48, 9% in YG vs 40, 0% in EG, p=0, 6). Median day of discharge was POD 8 for both groups (p= 0, 8). Conclusions: In high-volume centres ERAS protocols can be safely applied to elderly patients undergoing esophagectomy.