Is recovery enhancement after gastric cancer surgery really a safe approach for elderly patients?

作者全名：Li, Zi-Wei; Luo, Xiao-Juan; Liu, Fei; Liu, Xu-Rui; Shu, Xin-Peng; Tong, Yue; Lv, Quan; Liu, Xiao-Yu; Zhang, Wei; Peng, Dong

作者地址：[Li, Zi-Wei; Liu, Fei; Liu, Xu-Rui; Shu, Xin-Peng; Tong, Yue; Lv, Quan; Liu, Xiao-Yu; Zhang, Wei; Peng, Dong] Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, 1 Youyi Rd, Chongqing 400016, Peoples R China; [Luo, Xiao-Juan] Chongqing Med Univ, Affiliated Hosp 1, Dept Endoscopy Ctr, Chongqing 400012, Peoples R China

通信作者：Peng, D (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, 1 Youyi Rd, Chongqing 400016, Peoples R China.

来源：WORLD JOURNAL OF GASTROINTESTINAL ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001208073600018

JCR分区：Q2

影响因子：2.5

年份：2024

卷号：16

期号：4

开始页：　

结束页：　

文献类型：Article

关键词：Enhanced recovery after surgery; Gastric cancer; Elderly; Mortality

摘要：BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery (ERAS) in elderly patients with gastric cancer (GC). AIM To evaluate the safety of ERAS in elderly patients with GC. METHODS The PubMed, EMBASE, and Cochrane Library databases were used to search for eligible studies from inception to April 1, 2023. The mean difference (MD), odds ratio (OR) and 95% confidence interval (95%CI) were pooled for analysis. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores. We used Stata (V.16.0) software for data analysis. RESULTS This study consists of six studies involving 878 elderly patients. By analyzing the clinical outcomes, we found that the ERAS group had shorter postoperative hospital stays (MD = -0.51, I2 = 0.00%, 95%CI = -0.72 to -0.30, P = 0.00); earlier times to first flatus (defecation; MD = -0.30, I-2 = 0.00%, 95%CI = -0.55 to -0.06, P = 0.02); less intestinal obstruction (OR = 3.24, I2 = 0.00%, 95%CI = 1.07 to 9.78, P = 0.04); less nausea and vomiting (OR = 4.07, I2 = 0.00%, 95%CI = 1.29 to 12.84, P = 0.02); and less gastric retention (OR = 5.69, I2 = 2.46%, 95%CI = 2.00 to 16.20, P = 0.00). Our results showed that the conventional group had a greater mortality rate than the ERAS group (OR = 0.24, I2 = 0.00%, 95%CI = 0.07 to 0.84, P = 0.03). However, there was no statistically significant difference in major complications between the ERAS group and the conventional group (OR = 0.67, I2 = 0.00%, 95%CI = 0.38 to 1.18, P = 0.16). CONCLUSION Compared to those with conventional recovery, elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.

基金机构：Chongqing Medical University Program for Youth Innovation in Future Medicine [W0190]

基金资助正文：Supported by Chongqing Medical University Program for Youth Innovation in Future Medicine, No. W0190.