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A survey of pediatric surgeons' practices with enhanced recovery after children's surgery
Heather L Short1, Natalie Taylor2, Mitali Thakore2
1Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Insights
Pediatric surgeons are willing to adopt most Enhanced Recovery After Surgery (ERAS) elements for children
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Evidence-Based Medicine
Background:
- Enhanced Recovery After Surgery (ERAS) protocols optimize outcomes in adult abdominal surgery.
- Pediatric surgical populations may benefit from similar enhanced recovery pathways.
Purpose of the Study:
- To assess pediatric surgeons' perspectives on applying individual ERAS elements to pediatric surgery.
- To identify specific ERAS components that may be contentious in pediatric surgical practice.
Main Methods:
- An electronic survey was distributed to members of the American Pediatric Surgical Association.
- Respondents rated their willingness to implement 21 adult ERAS elements for adolescents undergoing elective colorectal surgery on a 5-point Likert scale.
- The survey achieved a 24% response rate (257/1052).
Main Results:
- A majority of surveyed pediatric surgeons (68.4%) reported familiarity with ERAS.
- Most respondents (67%) were willing to implement 14 of the 21 ERAS elements.
- Seven ERAS elements were identified as contentious, with surgeons expressing uncertainty or unwillingness to implement them.
Conclusions:
- Pediatric surgeons generally support the majority of ERAS principles for pediatric abdominal surgery.
- Further research is needed to confirm the safety and feasibility of implementing 7 specific ERAS elements in children.
- Tailoring ERAS protocols for pediatric populations requires careful consideration of specific elements.
Purpose:
Enhanced Recovery After Surgery (ERAS) protocols have been shown to improve outcomes in adult abdominal surgical populations. Our purpose was to survey pediatric surgeons' opinions regarding applicability of individual ERAS elements to children's surgery.
Methods:
A survey of the American Pediatric Surgical Association was conducted electronically. Using a 5-point Likert scale, respondents rated their willingness to implement 21 adult ERAS elements in an adolescent undergoing elective colorectal surgery.
Results:
Of an estimated 1052 members, 257 completed the survey (24%). The majority of the respondents (n=175, 68.4%) rated their familiarity with ERAS as "moderately", "very", or "extremely familiar". However only 19.2% (n=49) replied that they were "already implementing" an ERAS protocol in their practice. Most respondents replied that they were "already doing" or "definitely willing" to implement 14 of the 21 (67%) ERAS elements. For the remaining 7 elements, >10% of surgeons answered that they were only "somewhat willing" to, "uncertain" about or "unwilling" to implement these interventions.
Conclusions:
Most respondents were willing to implement the majority of adult ERAS concepts in children undergoing abdominal surgery. However, we identified 7 elements that remain contentious. Further investigation regarding the safety and feasibility of these elements is warranted before applying them to children's surgery.
Level Of Evidence:
Level V.
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