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Lee SS, Chern JY, Frey MK, et al. Enhanced recovery Pathways in gynecologic surgery: Are they safe and effective in the elderly?. Gynecol Oncol Rep. 2021;38:100862doi: 10.1016/j.gore.2021.100862.
Lee, S. S., Chern, J. Y., Frey, M. K., Comfort, A., Lee, J., Roselli, N., & Boyd, L. R. (2021). Enhanced recovery Pathways in gynecologic surgery: Are they safe and effective in the elderly?. Gynecologic oncology reports, 38100862. https://doi.org/10.1016/j.gore.2021.100862
Lee, Sarah S, et al. "Enhanced recovery Pathways in gynecologic surgery: Are they safe and effective in the elderly?." Gynecologic oncology reports vol. 38 (2021): 100862. doi: https://doi.org/10.1016/j.gore.2021.100862
Lee SS, Chern JY, Frey MK, Comfort A, Lee J, Roselli N, Boyd LR. Enhanced recovery Pathways in gynecologic surgery: Are they safe and effective in the elderly?. Gynecol Oncol Rep. 2021 Sep 20;38:100862. doi: 10.1016/j.gore.2021.100862. eCollection 2021 Nov. PMID: 34621945; PMCID: PMC8479239.
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Gynecol Oncol Rep. 2021 Sep 20;38:100862. doi: 10.1016/j.gore.2021.100862. eCollection 2021 Nov.

Enhanced recovery Pathways in gynecologic surgery: Are they safe and effective in the elderly?.

Gynecologic oncology reports

Sarah S Lee, Jing-Yi Chern, Melissa K Frey, Ashley Comfort, Jessica Lee, Nicole Roselli, Leslie R Boyd

Affiliations

  1. New York University School of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, New York, NY, United States.
  2. Moffitt Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Tampa, FL, United States.
  3. Weill Cornell Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, New York, NY, United States.
  4. Boston University Medical Center, Department of Obstetrics and Gynecology, Boston, MA, United States.
  5. University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Dallas, TX, United States.
  6. New York University School of Medicine, Department of Obstetrics and Gynecology.

PMID: 34621945 PMCID: PMC8479239 DOI: 10.1016/j.gore.2021.100862

Abstract

OBJECTIVE: To compare perioperative outcomes of the elderly versus non-elderly patients on ERPs undergoing laparotomy for gynecologic surgery.

METHODS: From January 2016 to June 2017, patients undergoing elective laparotomies for gynecologic surgery were enrolled in a perioperative ERP protocol. Outcomes were compared between the elderly (age ≥ 70 years) and the non-elderly (age ≤ 69 years). Primary outcomes were length of stay and perioperative complication rates. Comparisons were performed using chi-squared tests or Fisher's exact tests for categorical data and Student's

RESULTS: One hundred eighty-nine patients were enrolled in the study, including 16 patients ≥ 70 years old. The median age was 75 years for the elderly and 45 years for the non-elderly. Elderly patients were more likely to have more complex surgery and longer operative times (absolute median difference of 39 min). Despite the increasing complexity of surgical procedures for elderly patients, there were no statistically significant differences in serious inpatient complications (Clavien-Dindo score 3A or greater), pain and nausea scores, 30-day complications and readmission rates. Elderly patients had a longer median length of stay compared to non-elderly patients by one day (p < 0.001), however, this was not statistically significant on multivariate analysis.

CONCLUSION: In our series, elderly patients on the ERP had similar rates of complications and readmission when compared to non-elderly patients, despite undergoing more complex surgeries. This suggests that ERP may be feasible and safe in the elderly population undergoing elective gynecologic laparotomy.

© 2021 Published by Elsevier Inc.

Keywords: Elderly patients; Enhanced recovery after surgery; Enhanced recovery pathway; Gynecology; Surgical outcomes

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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