Compliance with an enhanced recovery pathway and postoperative outcomes in elderly colorectal cancer patients: a real-world cohort and structural pathway analysis.

Liping Feng, Qingyong Huang, Songchun Liu, Shuang Wu

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Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 authors.

Liping Feng *Department of Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524000, Guangdong Province, China.

Qingyong Huang *Department of General Surgery, Ezhou Central Hospital, Ezhou, 436000, Hubei Province, China.

Songchun LiuDepartment of Clinical Nutrition, Ezhou Central Hospital, Ezhou, 436000, Hubei Province, China.

Shuang WuDepartment of Colorectal Surgery, Tongde Hospital of Zhejiang Province, Xihu District, No. 234, Gucui Road, Xihu District, Hangzhou, 310000, Zhejiang Province, China. Shuang5545@outlook.com.ORCID http://orcid.org/0009-0000-0997-3069

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6 · The paper itself

Abstract

ERAS programmes are widely used in colorectal surgery, but the impact of overall pathway compliance on outcomes in elderly colorectal cancer patients and the mechanisms linking compliance to recovery are unclear. We retrospectively analysed 206 elderly patients (median age 72 years) who underwent elective colorectal cancer resection within an ERAS pathway (2020-2023). Overall ERAS compliance was classified as high (≥ 70%, n = 114) or low (< 70%, n = 92). Outcomes included major complications (Clavien-Dindo III-V), length of stay (LOS), Comprehensive Complication Index (CCI), time to first flatus/defecation, readmission, mortality, and hospital costs. Subgroup analyses and structural equation modelling (SEM) assessed direct and indirect pathways between compliance and outcomes. High compliance was associated with fewer major complications (16.7% vs 29.3%, P = 0.048), lower CCI (18.6 ± 9.5 vs 22.1 ± 10.4, P = 0.014), and shorter LOS (8.2 ± 2.6 vs 10.1 ± 3.1 days, P = 0.003). Gastrointestinal recovery was faster (flatus 2.3 ± 0.8 vs 2.9 ± 1.0 days; defecation 3.8 ± 1.1 vs 4.5 ± 1.2 days; both P < 0.001), and costs were lower (64.8 ± 15.2 vs 72.5 ± 18.1 × 10

Indexed as

Colorectal neoplasms/surgeryEnhanced recovery after surgeryPatient compliancePostoperative complications

Identifiers

PMID42053955

DOI10.1016/j.jss.2024.07.087

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