The Role of Enhanced Recovery Programmes in Elderly Patients Undergoing Thoracic Surgery

Purpose of Review An ageing population and increasing use of imaging techniques have resulted in a greater number of elderly patients being diagnosed with localised, early stage non-small cell lung cancer (NSCLC). Several physiologic factors contribute to the challenge of thoracic surgery in elderly patients: age-related decline in pulmonary function, comorbid disease such as ischaemic heart disease, diabetes and osteoporosis; and advanced COPD in lifelong smokers. This article will discuss the potential advantages of enrolling elderly patients undergoing thoracic surgery on an enhanced recovery after surgery programme and the effect of such programmes on patient outcomes. Recent Findings Several interventions implemented in the pre-, intra- and post-op periods have been shown to reduce morbidity and mortality in elderly patients undergoing pulmonary resection. No single intervention has the capacity to reduce morbidity and mortality in the elderly undergoing pulmonary resection; however, a series of interventions implemented as an ERAS programme has the potential to improved outcomes in this patient population.