{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:15:43Z","timestamp":1787163343766,"version":"build-2736575974"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009827","name":"Alexandria University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009827","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Enhanced Recovery After Surgery (ERAS) protocols are well-established in elective surgery, yet their role in emergency procedures remains underexplored \u2014 particularly in the elderly, a uniquely vulnerable subgroup. This study presents the first focused comparative analysis evaluating ERAS outcomes in elderly patients undergoing emergency surgery for perforated peptic ulcer (PPU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective comparative study analyzed 137 elderly patients (\u2265\u200960 years) who underwent emergency surgery for PPU from August 2020 to July 2024. Patients were divided into: ERAS group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200967) and conventional group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200970), based on their perioperative protocol of management. Primary outcomes included postoperative functional recovery parameters. Secondary outcomes encompassed postoperative complications, pain scores, length of hospital stay and readmission rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The ERAS group demonstrated significantly faster functional recovery across multiple parameters: earlier bowel movement (1.21\u2009\u00b1\u20090.34 vs. 2.20\u2009\u00b1\u20090.57 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), faster mobilization (1.26\u2009\u00b1\u20090.17vs 3.51\u2009\u00b1\u20090.60 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and shorter hospital stay (5.24\u2009\u00b1\u20090.57 vs. 7.03\u2009\u00b1\u20092.09 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Pain control was superior in the ERAS group, with consistently lower VAS scores and reduced opioid consumption (8.49\u2009\u00b1\u20090.59 vs. 18.73\u2009\u00b1\u20090.72\u00a0mg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Notably, postoperative nausea and vomiting were significantly reduced (22.4% vs. 41.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013). Complication rates were comparable between groups, with no increase in readmission and reoperation rates, suggesting the safety of ERAS implementation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This focused analysis provides evidence that ERAS protocols can be safely and effectively implemented in elderly patients undergoing emergency PPU repair, resulting in accelerated recovery, improved pain control, and reduced hospital stay without compromising safety. These findings challenge traditional conservative approaches to perioperative care in elderly emergency surgery patients. However, our findings primarily apply to a relatively stable \u2018young-elderly\u2019 subgroup and may not reflect outcomes in frailer or critically ill elderly populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-025-04188-0","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T08:48:34Z","timestamp":1760345314000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Implementation of enhanced recovery after surgery (ERAS) protocols in elderly patients undergoing emergency surgery for perforated peptic ulcer: a comparative analysis"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1920-6810","authenticated-orcid":false,"given":"Mohamed","family":"Wael","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2637-0176","authenticated-orcid":false,"given":"Ahmed S.","family":"Shehab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9905-8565","authenticated-orcid":false,"given":"Islam","family":"El-Sayes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4951-016X","authenticated-orcid":false,"given":"Mostafa Ibrahim Ahmed","family":"Seif-Eldeen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"4188_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13017-019-0283-9","volume":"15","author":"A Tarasconi","year":"2020","unstructured":"Tarasconi A, Coccolini F, Biffl WL, Tomasoni M, Ansaloni L, Picetti E, et al. 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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.Given the retrospective nature of the study, the requirement for informed consent was waived by the Alexandria University Ethical Committee on Human Research (IRB Number: 00012098).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"723"}}