Evidence map›Paper›PMID 42254924›Full record

ReviewFrontiers in surgery2026

Effectiveness of enhanced recovery after surgery protocols in elderly patients undergoing major abdominal surgery: a systematic review and meta-analysis.

Kexuan Zhu, Qingkun Zhou, Xuhui Xu, Zhengdong Wu, Kunfeng Ban, Gang Xu

Abstract readReview
In one paragraph

Review in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

6 authors.

Kexuan ZhuSchool of Medicine and Nursing, Nanjing University of Chinese Medicine Hanlin College, Taizhou, Jiangsu, China.
Qingkun ZhouDepartment of Geriatrics, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
Xuhui XuDepartment of Geriatrics, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
Zhengdong WuDepartment of General Surgery, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
Kunfeng BanDepartment of General Surgery, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
Gang XuDepartment of General Surgery, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Enhanced Recovery After Surgery (ERAS) protocols have been widely adopted in perioperative care, but their effectiveness and safety in elderly patients undergoing major abdominal surgery remain subjects of ongoing investigation. To systematically evaluate the effectiveness of ERAS protocols compared with conventional care in elderly patients (≥65 years) undergoing major abdominal surgery. Methods: A systematic search was conducted in PubMed, Cochrane Library, Embase, and Web of Science from inception to December 2024. Randomized controlled trials (RCTs) and prospective cohort studies comparing ERAS with conventional care in elderly patients undergoing major abdominal surgery were included. The primary outcome was length of hospital stay (LOS). Secondary outcomes included total complication rate, 30-day mortality, and 30-day readmission rate. ERAS components, protocol compliance, baseline characteristics, and complication definitions were extracted when available. Meta-analyses were performed using random-effects models with subgroup and sensitivity analyses. Results: Fifteen studies (6 RCTs and 9 prospective cohort studies) involving 2,397 patients were included. Most studies evaluated colorectal surgery, while two involved hepatectomy and two involved gastrectomy. ERAS pathways consistently included early feeding, early mobilization, and reduced routine tube use, but reporting of protocol details and compliance was variable; overall compliance was reported in 6 of 15 studies (range 42%-89.6%). ERAS significantly reduced LOS compared with conventional care (MD = -3.31 days, 95% CI: -3.74 to -2.88, Conclusions: ERAS protocols appear effective and generally safe in older patients undergoing major abdominal surgery, reducing hospital stay and postoperative complications without increasing readmission rates. However, interpretation should account for variability in ERAS implementation, incomplete compliance reporting, and the combination of randomized and prospective cohort evidence. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261381194, PROSPERO CRD420261381194.

Indexed as

abdominal surgeryelderlyenhanced recovery after surgeryERASgeriatricmeta-analysissystematic review

Identifiers

PMID42254924
PMCPMC13233427

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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.