ArticleFrontiers in surgery2025
RERAS-robotic colorectal resections and ERAS® in older adults: optimizing recovery or adding complexity?
Article in Frontiers in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Robotic versus laparoscopic surgery in older adults: a systematic review and meta-analysis of recovery-centered outcomes.Journal of robotic surgery · 2026Pooled it
- RERAS: does age define recovery? The role of patient characteristics and ERAS protocols in robotic colorectal surgery.Journal of robotic surgery · 2026Article
- A cost comparison between patients undergoing robotic colorectal surgery with and without a clinical pathway.Cost effectiveness and resource allocation : C/E · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Robot-assisted surgery (RAS) has established itself as a minimally invasive approach in colorectal surgery, although evidence on its integration with Enhanced Recovery After Surgery (ERAS®) protocols in older patients remains limited. This study aims to describe short-term outcomes of RAS combined with a perioperative treatment according to the ERAS® protocols in patients ≥70 years. Methods: This retrospective analysis of a prospectively maintained database includes all patients aged ≥70 years who underwent robotic colorectal resections at two German colorectal cancer centers between January 2019 and April 2024, managed perioperatively according to the ERAS® protocols. Primary endpoints were the patients' short-term perioperative outcomes, including duration of surgery, conversion rate, postoperative Intermediate-Care-Unit (IMC) admission, postoperative complications according to Clavien-Dindo, anastomotic leak and reoperation rate, length of hospital stay, and compliance to ERAS® guidelines. Results are presented descriptively without a comparator arm. Results: A total of 161 patients (99 colon resections and 62 rectal resections) were included over the study period. Median duration of surgery was 153 (IQR: 130-197) minutes for colon and 243 (IQR: 120-467) minutes for rectal resections. Conversion rates were 1% and 4.8% respectively. Postoperative IMC admission was required in 9.1% (9 Patients) after colon and 12.9% (8 Patients) after rectal-resections, based on individual clinical assesement. Anastomotic leaks occurred in 7 cases (7%) following colon resections, with a total reoperation rate of 10%. Among rectal resections, the anastomotic leakage rate was 9.7% (6 cases) with a total reoperation rate of 16.1%. ERAS® compliance was 91.3% for colon- and 85% for rectal resections. Within the rectal cohort, postoperative complications were associated with a substantially lower perioperative ERAS® compliance compared to patients without complications (73.3% vs. 90.7%). Hospital stay was 5 days (IQR: 4-6 days) for colon- and 6 days (IQR: 5-11 days) for rectal resections. The 30-day readmission rate was 4% (4 cases) for colon and 8% (5 cases) for rectal resections. Conclusion: The integration of RAS colorectal surgery within ERAS® protocols appears feasible and is associated with acceptable short-term outcomes in elderly and comorbid patients. Nonetheless, these results should be interpreted as descriptive observations rather than inferential evidence.
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