Key result
ERAS linked to shorter stays and faster recovery in elderly upper GI surgery without excess complications.
Why the study?
Evidence regarding the application of Enhanced Recovery After Surgery (ERAS) protocols in elderly patients undergoing upper gastrointestinal surgery remains limited despite their high prevalence of multimorbidity and frailty.
Do Enhanced Recovery After Surgery (ERAS) protocols improve postoperative recovery and maintain safety in elderly patients undergoing upper gastrointestinal surgery?
Do Enhanced Recovery After Surgery (ERAS) protocols improve postoperative recovery and maintain safety in elderly patients undergoing upper gastrointestinal surgery?
ERAS protocols are feasible and safe for elderly patients undergoing upper GI surgery, improving recovery metrics without increasing complications.
Answers are grounded in this paper and cite their sources.
Supports ERAS use in elderly upper GI surgery patients; extends colorectal RCT evidence to this frail population.
Background/Objectives: Enhanced Recovery After Surgery (ERAS) has substantially advanced perioperative care across multiple surgical disciplines. Research in colorectal surgery has clearly demonstrated the effectiveness of ERAS programs; however, evidence regarding the application of these protocols in elderly patients undergoing upper gastrointestinal (GI) surgery remains limited. This population has a high prevalence of multimorbidity, frailty, and diminished physiological reserve, factors that collectively increase vulnerability to postoperative complications and may influence adherence to ERAS pathways. Methods: This narrative review is based on a structured literature search of PubMed, Scopus, and Web of Science for studies published between 2000 and 2025. The search identified randomized controlled trials (RCTs), observational studies, meta-analyses, and clinical guidelines evaluating ERAS protocols in elderly patients undergoing upper GI surgery. Results: Available evidence indicates that ERAS protocols are feasible and safe in elderly patients undergoing upper GI surgery, including gastrectomy and esophagectomy. Studies consistently associate their implementation with shorter hospital stays, faster gastrointestinal recovery, and no significant increase in postoperative complications or readmission rates. However, heterogeneity in study designs, ERAS components, and definitions of ‘elderly’ limits comparability across studies. Conclusions: ERAS protocols represent a promising perioperative strategy for elderly patients undergoing upper GI surgery. When implemented within a multidisciplinary framework and tailored to patients’ frailty and comorbidities, these protocols may improve postoperative recovery while maintaining safety. Future research should prioritize multicenter RCTs to identify the most effective ERAS components and evaluate long-term clinical and functional outcomes in this population.
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Palomba et al. (2026) conducted a review in Elderly patients undergoing upper gastrointestinal (GI) surgery. Enhanced Recovery After Surgery (ERAS) protocols was evaluated on Hospital stay, gastrointestinal recovery, postoperative complications, and readmission rates. ERAS protocols in elderly patients undergoing upper GI surgery were associated with shorter hospital stays and faster recovery without significantly increasing complications or readmission rates.
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