Enhanced recovery after surgery (ERAS) program in elderly patients undergoing laparoscopic hepatectomy: a retrospective cohort study

BACKGROUND: Enhanced recovery after surgery (ERAS) has shown sufficient superiority in terms of cutting down hospital stay and costs, and reducing complications in patients undergoing laparoscopic hepatectomy (LH). However, the benefit of ERAS in elderly patients undergoing LH remains unclear, and clinical studies on this topic are still limited. METHODS: In total, 177 elderly patients (aged over 65 and underwent LH) were divided into two groups. The 107 patients in the control group received standard care, while the 70 patients in the ERAS group underwent the ERAS program after hepatectomy. The primary endpoint was the postoperative hospital stay. The secondary endpoints were resumption of oral intake, readmission rate and complications. RESULTS: ERAS had a positive effect on reducing length of hospital stay {6 [4–8] vs. 9 [7–14] days; P<0.001}. Although there was no significant reduction of overall complications in the ERAS group compared with the control group (0.500 vs. 0.626; P=0.097), the Clavien-Dindo classification of compliances in the ERAS group was lower among the patients with complications (Grade I: 0.829 vs. 0.597; P=0.018; Grade II: 0.143 vs. 0.328; P=0.044), which indicated that the patients in the control group might experience more severe complications. The readmission rates remained unaffected between the two groups. CONCLUSIONS: Consistent with younger patients, ERAS program is considered to be effective and safe, which can distinctly promote recovery after hepatectomy for elderly patients accepting LH.