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SPECIAL FEATURES OF PERIOPERATIVE PERIOD OF ELDERLY PATIENTS WITH COLORECTAL CANCER


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Abstract

Material and methds. prospective study enrolled 95 patients with colorectal cancer aged from 60 to 89 years. In the main group (n = 47) in the preoperative period sedation was cancelled, the cardiac therapy and fluid intake for 2-3 hours before submitting to surgery were carried out. In intraoperative period infusion volume was reduced to 1000-1500 ml, the ratio of colloids:crystalloids was 1:1-2:1. In the postoperative period infusion volume was 1000-1500 ml (balanced ionic solutions), fluid intake and oral diet in 3-4 and 6 hours after surgery, mobilization (lifting, walking) from 2nd day, continuous epidural analgesia for 4-5 days were carried out. In the control (n = 48) group during and after surgery the volume of infusion therapy were calculated according to the standard recommendations. Opioids and epidural analgesia were used. Monitoring of infusion therapy was made by bioimpendance, the level of pain, the volume of oral liquid and enteral feeding, time of first taking of solid food and first defecation were assessed. Results. infusion therapy limitation in patients of elder patients group in intra- and postoperative period didn`t lead to water disbalance. Early fluid intake and enteral nutrition after surgery didn`t lead to a clinically significant increase in side effects (nausea, vomiting), stimulated early food intake (p = 0,02). The use of postoperative epidural analgesia reduced the intensity of pain and allowed greater volume of physical activity of patients. Conclusion. our study demonstrated successful application of the reduced volume of infusion therapy, early enteral nutrition and mobilization, epidural analgesia in elderly patients.


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