Preparing enhanced recovery after surgery for implementation in pediatric populations

Area of Science:

• Perioperative medicine
• Pediatric surgery
• Clinical pathways

Background:

• Enhanced Recovery After Surgery (ERAS) programs standardize evidence-based practices to improve surgical outcomes and efficiency in adults.
• ERAS programs have demonstrated reductions in length of stay, complication rates, and enhanced patient satisfaction in adult populations.
• Widespread adaptation of ERAS programs for pediatric surgery remains limited due to a lack of direct evidence and varying acceptance among providers and families.

Discussion:

• Implementation of ERAS programs in pediatric colorectal surgery requires careful consideration of evidence translation from adult studies.
• Addressing provider and family acceptance is crucial for successful integration of ERAS principles in pediatric care.
• Standardizing perioperative care through ERAS pathways can potentially optimize outcomes for pediatric surgical patients.

Key Insights:

• Limited direct evidence currently exists for adapting adult ERAS pathways to pediatric surgery.
• A newly implemented ERAS program for pediatric colorectal surgery is described, highlighting initial experiences.
• Challenges include the translatability of adult evidence and varying stakeholder acceptance.

Outlook:

• Further research is needed to establish robust evidence for pediatric ERAS pathways.
• Broader implementation requires addressing specific pediatric needs and stakeholder engagement.
• Optimizing pediatric surgical care through standardized pathways like ERAS holds significant potential.