Effect of standardized algorithm for perioperative management on the results of right-sided hemicolectomy in elderly patients

Abstract

Introduction. Standardized protocols for perioperative management of patients are increasingly used in colorectal surgery. We compared the results of right-sided hemicolectomy in elderly patients before and after implementation of this protocol.Materials and methods. The results of a prospective database of the department of surgical oncology of Treatment and Rehabilitation Center for 2009–2016 years were analyzed. A comparative analysis of 86 case of elective right-sided hemicolectomy was performed in patients aged 60 years and over as a part of standardized protocol for perioperative management of patients, and 34 similar surgeries carried out earlier without compliance with the protocol. Clinically, there was no significant differences between groups.Results. In the study group we revealed statistically significant decrease in the number of sever (grade III–V by Clavien–Dindo) postoperative complications and mortality from 33 % to 13 % and from 12 % to 1 %, respectively. Also, despite the fact that surgical operations in the test group were carried out by less experienced surgeons, introduction of the unified surgical technique reduced median duration of the surgery from 185 to 165 minutes.Conclusion. Introduction of the standardized protocol for perioperative management of elderly and old patients, that need right-sided hemicolectomy, reduces the number of complications and lethal cases.

Keywords

• right-sided hemicolectomy
• old age
• perioperative management