老年胃切除ERAS指南韩国

World JournalWorld J Surgof SurgeryCrossMarkD0110.1007/s00268-016-3845-yORIGINAL SCIENTIFIC REPORTCompliance with Guidelines of Enhanced Recovery After Surgeryin Elderly Patients Undergoing GastrectomyOh Jeong'Young Kyu Park'.Mi Ran Jung'.Seong Yeob Ryu'Socicte Internationale de Chirurgie 2016AbstractBackground Enhanced recovery after surgery (ERAS)aims at expediting postoperative recovery by implementingspecific strategies in perioperative management.However,the tolerance to such fast-tracking protocols is underdebate,especially in elderly patients.We aimed to investigate rate of compliance with the main ERAS guidelines inelderly gastrectomy patients.Methods Using data for 168 gastric cancer patients who underwent ERAS after gastrectomy as part of Clinical TrialNCT01653496,we calculated the rates of compliance with nine main ERAS guidelines and compared the compliancerates of elderly (70 years)and non-elderly (<70 years)patients.Surgical outcomes and fulfillment of criteria forpostoperative discharge were also compared.Results The study included 55 elderly and 113 non-elderly patients.There were no significant differences betweenthese groups of patients with respect to operative techniques and tumor stage.Except for restricted intravenous fluidadministration,the patients in both groups showed very high compliance rates (>90%)for every ERAS guideline.Notably,the overall compliance rates did not differ significantly between the groups.Postoperatively,the mean timeto fulfillment of discharge criteria was slightly longer for elderly patients (4.7 vs.4.2 days,p =0.005),but therewere no significant differences between the groups with respect to the incidence of postoperative complications,length of hospitalization,and readmission rate.Conclusion Compliance of the medically and physically fit elderly patients with the main ERAS guidelines iscomparable to that of non-elderly patients,and such protocols can be safely applied to elderly patients withoutsignificant modification.Introduction20%of such patients are older than 70 years [1].Becauseof frequent underlying comorbidities and low physiologicalThe incidence of gastric cancer is known to increase withreserve,elderly surgical patients tend to exhibit greater riskage.In Korea,the mean age of the patients who undergoof complications and longer postoperative convalescencesurgery for gastric cancer is approximately 60 years,and12];therefore,tailored perioperative management should beadministered in such patients.Protocols of enhanced recovery after surgery (ERAS)☒Oh Jeongare becoming increasingly common in the management ofsurgeonjeong @gmail.comabdominal surgery patients.ERAS involves a combination1Division of Gastroenterological Surgery.Department ofof evidence-based perioperative strategies that aims atSurgery.Chonnam National University College of Medicine.reducing surgical stress and expediting postoperativeIlsim-ri 160.Hwasun-eup.Hwasun-gun,recovery [3].A number of studies have shown that ERASJeolla