Scholarlink

<p>Age is frequently considered a major determinant of postoperative recovery after colorectal surgery and is often perceived as a limiting factor for an enhanced recovery after surgery (ERAS<sup>®</sup>) pathway. The integration of ERAS<sup>®</sup> with a robotic surgical approach (RERAS-concept) may be associated with synergistic effects especially for this group of patients. However, real-world-data evaluating age-related differences in postoperative recovery under RERAS conditions remain limited. This retrospective analysis of a prospectively maintained database included all elective robotic colorectal resections performed between January 2019 and April 2024 under a fully standardized ERAS<sup>®</sup>-protocol. Patients were categorized into younger (≤ 69 years) and older (≥ 70 years) adults. The primary endpoint was the comparison of short-term perioperative outcomes. Secondary endpoints comprised functional recovery parameters and perioperative ERAS<sup>®</sup> compliance. 344 robotic colorectal resections were analyzed (219 colon and 125 rectal resections). Older adults presented with increased frailty levels across both colon and rectal resections (mFI-5 all p = &lt; 0.0001). In colon resections, this was accompanied by significantly higher preoperative risk profiles, reflected by a greater proportion of ASA III patients (72.1% vs. 40.7%; <i>p</i> &lt; 0.0001), while intraoperative characteristics, postoperative morbidity and length of hospital stay were comparable between age groups. Older adults achieved oral pain control earlier (1 vs. 2 days; <i>p</i> = 0.0410), reported lower postoperative pain scores from the day of surgery through postoperative day 3 (all <i>p</i> &lt; 0.05) and demonstrated greater mobilization on postoperative day 3 (6 vs. 5&#xa0;h; <i>p</i> = 0.0298). In rectal resections, younger patients more frequently received neoadjuvant therapy (59.1% vs. 39%; <i>p</i> = 0.0248). Duration of surgery was shorter in older adults (229 vs. 245&#xa0;min; <i>p</i> = 0.0176), while the other endpoints were comparable between cohorts. In this real-world cohort, robotic colorectal surgery within a standardized ERAS<sup>®</sup> pathway resulted in comparable postoperative recovery across age groups, with statistically significant advantages in pain control and mobilization favoring older adults, supporting age-independent implementation of the RERAS concept. </p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

RERAS: does age define recovery? The role of patient characteristics and ERAS protocols in robotic colorectal surgery

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月20日

查看全文
  • Mohamad El-Ahmar,
  • S. Abdelhadi,
  • F. Peters,
  • C. Reissfelder,
  • S. Hetjens,
  • B. Mazul,
  • A. Armbruster,
  • F. Spans,
  • M. Dietrich,
  • M. Green,
  • S. Ulmer,
  • M. Ristig,
  • J.-P. Ritz,
  • M. Karg

摘要

Age is frequently considered a major determinant of postoperative recovery after colorectal surgery and is often perceived as a limiting factor for an enhanced recovery after surgery (ERAS®) pathway. The integration of ERAS® with a robotic surgical approach (RERAS-concept) may be associated with synergistic effects especially for this group of patients. However, real-world-data evaluating age-related differences in postoperative recovery under RERAS conditions remain limited. This retrospective analysis of a prospectively maintained database included all elective robotic colorectal resections performed between January 2019 and April 2024 under a fully standardized ERAS®-protocol. Patients were categorized into younger (≤ 69 years) and older (≥ 70 years) adults. The primary endpoint was the comparison of short-term perioperative outcomes. Secondary endpoints comprised functional recovery parameters and perioperative ERAS® compliance. 344 robotic colorectal resections were analyzed (219 colon and 125 rectal resections). Older adults presented with increased frailty levels across both colon and rectal resections (mFI-5 all p = < 0.0001). In colon resections, this was accompanied by significantly higher preoperative risk profiles, reflected by a greater proportion of ASA III patients (72.1% vs. 40.7%; p < 0.0001), while intraoperative characteristics, postoperative morbidity and length of hospital stay were comparable between age groups. Older adults achieved oral pain control earlier (1 vs. 2 days; p = 0.0410), reported lower postoperative pain scores from the day of surgery through postoperative day 3 (all p < 0.05) and demonstrated greater mobilization on postoperative day 3 (6 vs. 5 h; p = 0.0298). In rectal resections, younger patients more frequently received neoadjuvant therapy (59.1% vs. 39%; p = 0.0248). Duration of surgery was shorter in older adults (229 vs. 245 min; p = 0.0176), while the other endpoints were comparable between cohorts. In this real-world cohort, robotic colorectal surgery within a standardized ERAS® pathway resulted in comparable postoperative recovery across age groups, with statistically significant advantages in pain control and mobilization favoring older adults, supporting age-independent implementation of the RERAS concept.