Evidence map›Paper›PMID 38942944›Full record

GuidelineSurgical endoscopy2024

EAES/SAGES evidence-based recommendations and expert consensus on optimization of perioperative care in older adults.

Deborah S Keller, Nathan Curtis, Holly Ann Burt, Carlo Alberto Ammirati, Amelia T Collings, Hiram C Polk, Francesco Maria Carrano, Stavros A Antoniou, Nader Hanna, Laure-Meline Piotet and 19 more

Abstract readConsensus StatementPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Roy adaptation model-based patient education for elderly patients undergoing laparoscopic radical gastrectomy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Trial
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Review
  11. Review
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Deborah S KellerDepartment of Digestive Surgery, University of Strasbourg, Strasbourg, FR, USA.ORCID 0000-0002-8645-6206
Nathan CurtisSurgical Unit, Dorset County Hospital, Dorchester, Dorset, UK.
Holly Ann BurtSAGES, Los Angeles, CA, USA.ORCID 0000-0002-8803-3776
Carlo Alberto AmmiratiDepartment of Surgical Sciences, University of Torino, Turin, Italy.ORCID 0000-0002-9892-4572
Amelia T CollingsDepartment of Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
Hiram C PolkDepartment of Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
Francesco Maria CarranoDepartment of General and Minimally Invasive Surgery, Busto Arsizio Circolo Hospital, ASST-Valle Olona, Varese, Italy.ORCID 0000-0003-1189-9907
Stavros A AntoniouDepartment of General Surgery, Papageorgiou General Hospital, Thessaloniki, Greece.
Nader HannaDepartment of Surgery, Queen's University, Kingston, ON, Canada.
Laure-Meline PiotetDepartment of Surgery, University Hospital CHUV, Lausanne, Switzerland.
Sarah HillDepartment of Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
Anne C M CuijpersDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Patricia TejedorDepartment of Colorectal Surgery, University Hospital Gregorio Marañón, Madrid, Spain.ORCID 0000-0001-8648-7697
Marco MiloneDepartment of Clinical and Surgical Gastrointestinal Diseases, University of Naples "Federico II", Via Pansini 5, Naples, Italy.
Eleni AndriopoulouDepartment of Surgery, Hellenic Red Cross Korgialeneio Benakeio NHS, Athens, Greece.
Christos KontovounisiosDepartment of Surgery and Cancer, Imperial College London, Chelsea and Westminster Campus and the Royal Marsden Hospital, London, UK.
Ira L LeedsDepartment of Surgery, Yale School of Medicine, New Haven, CT, USA.
Ziad T AwadDepartment of Surgery, University of Florida, Jacksonville, FL, USA.
Meghan Wandtke BarberDepartment of Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
Mazen Al-MansourDepartment of Surgery, College of Medicine, University of Florida, Gainesville, FL, USA.
George NassifDepartment of Colorectal Surgery, AdventHealth, Orlando, FL, USA.
Malcolm A WestCancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
Aurora D PryorLong Island Jewish Medical Center and System Chief for Bariatric Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Great Neck, NY, USA.
Franco CarliDepartment of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
Nicholas DemartinesDepartment of Surgery, University Hospital CHUV, Lausanne, Switzerland.
Nicole D BouvyInnovative Surgical Techniques, Endoscopic and Endocrine Surgery, Department of Surgery, Maastricht University Medical Center, Amsterdam, Netherlands.
Roberto PasseraDivision of Nuclear Medicine, University of Torino, Turin, Italy.
Alberto ArezzoDepartment of Surgical Sciences, University of Torino, Turin, Italy.
Nader FrancisDepartment of Surgery, Yeovil District Hospital, Higher Kingston, Yeovil, UK. n.francis@griffininstitute.org.uk.ORCID 0000-0001-8498-9175

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs the population ages, more older adults are presenting for surgery. Age-related declines in physiological reserve and functional capacity can result in frailty and poor outcomes after surgery. Hence, optimizing perioperative care in older patients is imperative. Enhanced Recovery After Surgery (ERAS) pathways and Minimally Invasive Surgery (MIS) may influence surgical outcomes, but current use and impact on older adults patients is unknown. The aim of this study was to provide evidence-based recommendations on perioperative care of older adults undergoing major abdominal surgery.

methodsExpert consensus determined working definitions for key terms and metrics related to perioperative care. A systematic literature review and meta-analysis was performed using the PubMed, Embase, Cochrane Library, and Clinicaltrials.gov databases for 24 pre-defined key questions in the topic areas of prehabilitation, MIS, and ERAS in major abdominal surgery (colorectal, upper gastrointestinal (UGI), Hernia, and hepatopancreatic biliary (HPB)) to generate evidence-based recommendations following the GRADE methodology.

resultOlder adults were defined as 65 years and older. Over 20,000 articles were initially retrieved from search parameters. Evidence synthesis was performed across the three topic areas from 172 studies, with meta-analyses conducted for MIS and ERAS topics. The use of MIS and ERAS was recommended for older adult patients particularly when undergoing colorectal surgery. Expert opinion recommended prehabilitation, cessation of smoking and alcohol, and correction of anemia in all colorectal, UGI, Hernia, and HPB procedures in older adults. All recommendations were conditional, with low to very low certainty of evidence, with the exception of ERAS program in colorectal surgery.

conclusionsMIS and ERAS are recommended in older adults undergoing major abdominal surgery, with evidence supporting use in colorectal surgery. Though expert opinion supported prehabilitation, there is insufficient evidence supporting use. This work has identified evidence gaps for further studies to optimize older adults undergoing major abdominal surgery.

Indexed as

Evidence-Based MedicinePerioperative CareAgedAged, 80 and overConsensusEnhanced Recovery After SurgeryHumansMinimally Invasive Surgical ProceduresAbdominal SurgeryElderlyEnhanced recovery after surgery (ERAS)FrailFrailtyLaparoscopyOlder adults/agedPerioperative carePrehabilitationRobotic surgical procedures

Identifiers

PMID38942944
PMCPMC11289045

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.