Multimodal Perioperative Rehabilitation for Colonic Surgery in the Elderly

Rumstadt, B.; Guenther, Nina; Wendling, P; Engemann, R.; Germer, C. T.; Schmid, Michael; Kipfmueller, K.; Walz, Martin K.; Schwenk, W.

doi:10.1007/s00268-009-0018-2

Cited by 40 publications

(47 citation statements)

References 43 publications

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“…Six of the nine studies reported lower readmission rates for the older group (13,23-25, 27,28), but this was only a statistically significant lower rate in one study (27).…”

Section: Studies Comparing Older To Younger Patients In Erasmentioning

confidence: 88%

“…Mortality rates varied greatly across the 6 studies which reported on them (22)(23)(24)(25)27,28). In the 4 studies where mortality rates were low, there was little difference between age groups (22,24,27,28).…”

Section: Studies Comparing Older To Younger Patients In Erasmentioning

confidence: 99%

“…Complication rates ranged from 22.9 to 63%, the highest being in PD, without statistical significance between younger and older patient (27) reported a statistically significant difference in favour of younger over older (80+ and 79+) patients, in general and surgical post operative complications retrospectively. Five of the studies (13,22,24,26,28).…”

Section: Studies Comparing Older To Younger Patients In Erasmentioning

confidence: 99%

“…In the 4 studies where mortality rates were low, there was little difference between age groups (22,24,27,28).…”

Section: Studies Comparing Older To Younger Patients In Erasmentioning

confidence: 99%

“…In the 3 RCTs, post operative complication rates were [18] RCT Acceptable 1+ Wang et al [19] RCT Acceptable 1+ Partelli et al [20] Cohort Acceptable 2+ Kisialueski et al [21] Cohort Acceptable 2+ Baek et al [22] Cohort Acceptable 2+ Coolsen et al [23] Cohort High quality 2++ Khan et al [24] Cohort Acceptable 2+ Pawa et al [25] Cohort Acceptable 2+ Pedziwiatr et al [26] Cohort Acceptable 2+ Rumstadt et al [27] Cohort Acceptable 2+ Walter et al [28] Cohort Acceptable 2+ Gonzalez-Ayora et al [29] Cohort Acceptable 2+ ERAS in Emergency Gonenc et al [30] RCT Low quality 1-Lohsiriwat et al [31] Cohort High quality 2++ Wisely et al [32] Cohort Acceptable 2+ Roulin et al [33] Cohort Acceptable 2+ Verheijen et al [13] Cohort Acceptable 2+ reduced considerably from 18% to 5% (17), 58.6% to 27.4% (18) and 21% to 5% (18) and more notably when laparoscopy was used for all surgeries (17,19). LOS was reduced by 1.5 to 3.5 and 4 days (17)(18)(19).…”

Section: Studies Comparing Eras To Conventional Care In Elderly Patimentioning

confidence: 99%

See 4 more Smart Citations

Enhanced Recovery After Surgery (ERAS) - The Evidence in Geriatric Emergency Surgery: A Systematic Review

Paduraru¹,

Ponchietti²,

Casas³

et al. 2017

chr

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“…Six of the nine studies reported lower readmission rates for the older group (13,23-25, 27,28), but this was only a statistically significant lower rate in one study (27).…”

Section: Studies Comparing Older To Younger Patients In Erasmentioning

confidence: 88%

Section: Studies Comparing Older To Younger Patients In Erasmentioning

confidence: 99%

Section: Studies Comparing Older To Younger Patients In Erasmentioning

confidence: 99%

“…In the 4 studies where mortality rates were low, there was little difference between age groups (22,24,27,28).…”

Section: Studies Comparing Older To Younger Patients In Erasmentioning

confidence: 99%

Section: Studies Comparing Eras To Conventional Care In Elderly Patimentioning

confidence: 99%

See 3 more Smart Citations

Enhanced Recovery After Surgery (ERAS) - The Evidence in Geriatric Emergency Surgery: A Systematic Review

Paduraru¹,

Ponchietti²,

Casas³

et al. 2017

chr

View full text Add to dashboard Cite

Colorectal Surgery in the Elderly

Gachabayov

Bergamaschi

2020

Surgical Decision Making in Geriatrics

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Optimizing Outcomes with Enhanced Recovery

Thacker

Morin

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Concepts• Enhanced recovery is the process of defining modifiable sources of perioperative stress to the surgical patient and applying standardized evidence-based interventions through all phases of care to avoid complications, facilitate faster recovery and discharge (without increasing readmission rates), and reduce hospital costs. • Champions from surgery, anesthesia, and nursing are essential to the ERAS team, while other members for protocol creation include pharmacy, IT, nutrition, and administration. • Key elements of patient care delivery can be broken down into five phases, each assigned to and delivered by a different team while certain elements present across phases: preoperative, perioperative, intraoperative, postoperative, and post-discharge. • Implementation of the Enhanced Recovery Program, ERP, requires order sets, team education, and administrative help as well as databases to facilitate data collection and ensure optimal compliance and quality control. • ERAS principles are widely applicable and have been proven safe and beneficial in emergency and IBD patients, those with diverting ostomies, and elderly patients, realizing that readiness for discharge rather than length of stay is a more accurate outcome measure. • Moving forward, technology will assist in gathering patient recovery-centric outcome measures in addition to the traditional audit measures to further quality improvement efforts.Intrinsic to the personality of a surgeon is the drive toward perfect outcomes. Benchmarking, quality improvement comparisons, and inherent competitiveness all allow surgeons the means to evaluate their performance. Enhanced recovery principles, by contrast, focus on intervention elements. Specifically, enhanced recovery focuses on the surgical stress imposed on unique patient populations. This chapter focuses on enhanced recovery efforts, details, challenges, and future directions in the elective colorectal surgery patient.

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Multimodal Perioperative Rehabilitation for Colonic Surgery in the Elderly

Abstract: Although the overall morbidity did increase with age, it was still less when compared to that of historical groups with traditional care. Therefore, multimodal perioperative rehabilitation should be recommended for the elderly.

Cited by 40 publications

References 43 publications

Enhanced Recovery After Surgery (ERAS) - The Evidence in Geriatric Emergency Surgery: A Systematic Review

Enhanced Recovery After Surgery (ERAS) - The Evidence in Geriatric Emergency Surgery: A Systematic Review

Colorectal Surgery in the Elderly

Optimizing Outcomes with Enhanced Recovery

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