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Development of an enhanced recovery protocol for children undergoing gastrointestinal surgery

Mehul V Raval1, Kurt F Heiss

  • 1Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.

Current Opinion in Pediatrics
|April 10, 2018
PubMed

Insights

Enhanced recovery protocols (ERPs) improve pediatric gastrointestinal surgery outcomes. This review details ERP development and implementation, showing reduced hospital stays and narcotic use in children.

Area of Science:

  • Pediatric Surgery
  • Surgical Outcomes
  • Enhanced Recovery Protocols

Background:

  • Enhanced recovery protocols (ERPs) are established for adult surgery, improving outcomes.
  • Pediatric ERPs are less defined, necessitating tailored development.
  • Gastrointestinal surgery in children presents unique challenges for recovery.

Purpose of the Study:

  • To describe the development and implementation of an ERP for pediatric gastrointestinal surgery.
  • To adapt existing ERP components for a pediatric population.
  • To evaluate the feasibility and impact of a pediatric ERP.

Main Methods:

  • Literature review of adult and pediatric ERP components.
  • National survey of pediatric surgeons.
  • Multidisciplinary expert panel for appropriateness assessment.
  • Single-center pilot implementation and data analysis.

Main Results:

  • Successful development and implementation of a pediatric gastrointestinal ERP.
  • Increased utilization of ERP elements over time.
  • Decreased length of stay, time to regular diet, narcotic use, and fluid administration.
  • Stable or improved complication and readmission rates.

Conclusions:

  • Pediatric ERPs for gastrointestinal surgery are feasible and safe.
  • ERPs are associated with improved patient outcomes in children.
  • Further validation and expansion of ERPs are recommended for pediatric surgical care standards.
Abstract

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