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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Iwanaga, Naoki Takeda, Yoshinori Yoshioka, Ryuji Mise, Yoshihiro Sugo, Hiroyuki Saiura, Akio |
| Abstract | Background Although pancreaticoduodenectomy (PD) for pancreatic or periampullary cancer is the gold standard treatment regardless of patient age, patients aged 80 years or older have poor postoperative short-term outcomes because of their poor functional status and many medical comorbidities. Postoperative rehabilitation in octogenarians could improve postoperative outcomes; however, its effect remains unclear. Methods This retrospective study included patients who underwent PD at two institutions between January 2019 and December 2022. All patients were managed using the enhanced recovery after surgery (ERAS) protocol, and elderly patients or those with loss of muscle mass or frailty underwent additional perioperative rehabilitation. Postoperative short-term outcomes were compared between the octogenarians and non-octogenarians. Results We reviewed 251 patients including 44 octogenarians (17.5%). Octogenarians had higher rates of comorbidity (78.9% vs. 55.1%, P = 0.049) and sarcopenia (31.8% vs. 16.4%, P = 0.018) and a more impaired nutritional status than non-octogenarians and received postoperative rehabilitation more frequently (86.4% vs. 44.0%, P < 0.001, respectively). Under the rehabilitation-enhanced ERAS protocol, the postoperative major complication rate (25.0% vs. 24.6%, P = 0.960), the length of hospital stay (LOS) (P = 0.435), and the length of functional recovery (LOFR) (P = 0.110) did not differ between the two groups. In the multivariate analysis, age ≥ 80 years was not determined as a risk factor for major complications. Conclusions Despite the poor functional and nutritional status of octogenarians, their postoperative major complication rates, LOS, and LOFR after PD were comparable with those of non-octogenarians under the rehabilitation-enhanced ERAS protocol. |
| Related Links | https://bmcsurg.biomedcentral.com/counter/pdf/10.1186/s12893-024-02656-0.pdf |
| Ending Page | 10 |
| Page Count | 10 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712482 |
| DOI | 10.1186/s12893-024-02656-0 |
| Journal | BMC Surgery |
| Issue Number | 1 |
| Volume Number | 24 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2024-11-12 |
| Access Restriction | Open |
| Subject Keyword | Surgery Internal Medicine Sarcopenia Pancreaticoduodenectomy Octogenarians Rehabilitation |
| Content Type | Text |
| Resource Type | Article |
| Subject | Surgery |
| Journal Impact Factor | 1.6/2023 |
| 5-Year Journal Impact Factor | 1.9/2023 |
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