{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:18:29Z","timestamp":1788585509568,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This retrospective study aimed to assess the clinical effectiveness of a multimodal perioperative care program in reducing postoperative complications in elderly patients undergoing gastrectomy for gastric cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Overall, 1285 patients aged \u2265\u200975\u2009years who underwent curative gastrectomy were classified into pre\u2010program (2008\u20132018,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009965) and post\u2010program (2020\u20132024,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009320) groups. The program consisted of preoperative nutritional counseling, oral care, swallowing and physical function screening, and targeted rehabilitation. The clinical characteristics and surgical outcomes of the two groups were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the post\u2010program group, 314 patients underwent swallowing screening, with 108 receiving targeted speech\u2013language therapy and 49 being prescribed a dysphagia diet. Physical function screening was conducted on 281 patients, with 204 receiving perioperative exercise therapy. Program implementation was significantly associated with a lower incidence of overall complications (21% vs. 40%), surgical (13% vs. 21%) and non\u2010surgical complications (7% vs. 17%), pneumonia (4% vs. 9%), and delirium (3% vs. 7%). Multivariate analysis revealed that the program was independently associated with a significantly decreased incidence of overall complications (odds ratio [OR]: 0.431,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and non\u2010surgical complications (OR: 0.309,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Meanwhile, the reduction in the incidence of surgical complications was not statistically significant (OR: 0.696,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.094).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multimodal perioperative care program may effectively reduce postoperative complications, particularly non\u2010surgical complications such as pneumonia, in elderly patients with gastric cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.70194","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T23:24:19Z","timestamp":1770765859000},"page":"1031-1041","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of a Multimodal Perioperative Care Program With Postoperative Complications in Elderly Patients Undergoing Gastrectomy for Gastric Cancer"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5245-2493","authenticated-orcid":false,"given":"Keiichi","family":"Fujiya","sequence":"first","affiliation":[{"name":"Division of Gastric Surgery Shizuoka Cancer Center  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Fuseya","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation Medicine Shizuoka Cancer Center  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Yonenaga","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation Medicine Shizuoka Cancer Center  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Sanada","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation Medicine Shizuoka Cancer Center  Shizuoka 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