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. 2026 Jan 19;41(1):37.
doi: 10.1007/s00384-025-05075-6.

Short-term outcomes of minimally invasive surgery in older colorectal cancer patients in the era of enhanced recovery after surgery: is a "one-size-fits-all" strategy sufficient?

Zhen-Hao Yu  1   2 , Bor-Kang Jong  1   2 , Yu-Jen Hsu  1   2 , Jeng-Fu You  1   2 , Ching-Chung Cheng  1   2 , Chun-Kai Liao  1   2 , Yih-Jong Chern  3   4   5
Affiliations

Short-term outcomes of minimally invasive surgery in older colorectal cancer patients in the era of enhanced recovery after surgery: is a "one-size-fits-all" strategy sufficient?

Zhen-Hao Yu et al. Int J Colorectal Dis. .

Abstract

Background: An enhanced recovery protocol (ERP) comprises a series of elements aimed at optimizing and standardizing perioperative care. Therefore, in this study, we aimed to evaluate the safety and feasibility of a modified enhanced recovery after surgery (ERAS) protocol following colorectal surgery in older adults aged ≥ 65 years.

Materials and methods: Patients aged ≥ 65 years who underwent minimally invasive colorectal cancer surgery at a tertiary referral hospital in Taiwan between 2018 and 2022 were reviewed retrospectively. Patients were divided into ERAS and traditional care groups according to the perioperative care strategy. The primary outcome was the short-term complication rate. However, the secondary outcomes were postoperative hospital stay, reoperation, readmission, and 30-day mortality rates.

Results: Overall, 1392 patients were enrolled, including 550 and 842 in the ERAS and traditional care groups, respectively. Demographic characteristics, including comorbidities, perioperative characteristics, and pathological staging, were not statistically significant. The patients' short-term complication rate was lower in the ERAS group (aged 65-80 years) than in the traditional care group (29 (7.2%) vs. 75 (11.5%), P = 0.026). However, the short-term complication rate did not differ between patients aged > 80 years (24 (16%) vs. 36 (19%), P = 0.438). In addition, the mean postoperative hospital stay was shorter in the ERAS group (7.5 ± 8.9 days vs 9.7 ± 10.0 days, P < 0.001). However, there were no differences in other secondary outcomes, including reoperation, readmission, and 30-day mortality rates.

Conclusion: Minimally invasive colorectal cancer surgery within the ERAS program is safe and effective in patients aged 65-80 years.

Keywords: Colorectal cancer; ERAS; Enhanced recovery protocol; Older patients; Surgery.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol was approved by the institutional review board of Chang Gung Memorial Hospital Linkou branch as approval number 202401646B0. Due to the retrospective design of the study, the local ethic committee confirmed that informed consent was not necessary from participants. Consent for publication: All authors have read and approved the final manuscript and consent to its publication. Conflict of interest: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow chart
See this image and copyright information in PMC

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