Goal of Study: ERAS programs have proven to reduce morbidity and hospital length of stay (LOS) in colorectal surgery. However, the feasibility of these programs in elderly patients has been questioned. The aim of this study is to assess the implementation of an ERAS program in elderly patients based on LOS,
readmission rates and postoperative Clavien-Dindo complications.
Materials: a total of 123 patients were included. We compared the first 57 consecutive patients that participated in the ERAS group (from May 2016 to January 2017) with 66 consecutive patients (preERAS group) that were operated prior to implementation of the program (from January to December 2015). The
inclusion criteria were: elective colorectal surgery, ≥70 years old, appropiate cognitive state and ASA I-II-III. The exclusion criteria were: urgent surgery and existence of higher concomitant surgical processes. All variable data were descriptively analyzed via SPSS version 20.0. The results are presented as number of patients (%) (ERAS group versus preERAS group) or mean±standard deviation. Chi-square, Fisher exact test and t Student test were applied as appropiate. Results were considered statistically significant when p value‹0.05.
Results: the two groups were homogeneous. No statistically significant differences were found in terms of age, sex, ASA, diagnosis, TNM stage in colorectal cancer, preoperative hemoglobin, length of surgery...
The average compliance with the ERAS protocol was 74.7%. The ERAS program decreased LOS (10.1±3.9 in the ERAS group versus 12.2±4.6, p 0.009 in the preERAS group), but not the 30-days readmission rates (5 (8.8%) in the ERAS group versus 6 (9.1%) in the preERAS group, p 0.951) or the number of postoperative complications (21 (36.8%) vs 29 (43.9%), p 0.42) or the rate or reinterventions (4
(7%) vs 8 (12.1%), p 0.341). ERAS improved secondary variables in a statistically significant way: more laparoscopic surgery (20 (35.1%) vs 10 (15.2%), p 0.010); lower admnistration of fluid therapy (cristalloids and colloids) during the intraoperative period (p<0.001); greater use of regional analgesia in the
intraoperative period (p<0.001); more rapid adherence to ambulation (p<0.001), a faster onset of oral liquid diet (p<0.001) and lower requeriments of opioids in the postoperative period (p<0.001).
Conclusion: ERAS after elective colorectal surgery in elderly patients present as safe as feasible. It shortened LOS without increasing 30-days readmission rates.

01 / Enhanced Recovery After Surgery (ERAS) care after elective colorectal surgery in elderly patients. Outcomes of a study in the University Hospital of Guadalajara, Spain.