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Introducing enhanced recovery after surgery protocol in pediatric surgery

Anna Modrzyk1, Michał Jerzy Pasierbek1, Wojciech Korlacki1

  • 1Department of Children's Developmental Defects Surgery and Traumatology, Medical University of Silesia, Zabrze, Poland.

Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University
|August 22, 2020
PubMed

Insights

Implementing enhanced recovery after surgery (ERAS) protocols in pediatric reverse stoma surgery significantly reduced length of stay and time to oral intake. This approach improves outcomes and decreases metabolic stress in young patients.

Area of Science:

  • Pediatric Surgery
  • Perioperative Care
  • Surgical Outcomes

Background:

  • Enhanced Recovery After Surgery (ERAS) is a comprehensive perioperative protocol optimizing patient care.
  • ERAS protocols have transformed adult surgical recovery and are being adapted for pediatric populations.
  • This study focuses on the application of ERAS in pediatric reverse stoma surgery.

Purpose of the Study:

  • To introduce a novel pediatric ERAS protocol for reverse stoma surgery.
  • To compare outcomes of pediatric patients managed with the ERAS protocol versus those from a pre-ERAS period.
  • To evaluate the impact of ERAS on key recovery metrics.

Main Methods:

  • A retrospective comparative study design was employed.
  • Patient data from pre-ERAS (2016-2017, n=14) and ERAS (2018-2019, n=13) periods were analyzed.
  • Key metrics included: Total Parenteral Nutrition (TPN) duration, time to oral fluids, time to regular diet, time to stooling, and Length of Stay (LOS).

Main Results:

  • Length of Stay (LOS) decreased from 8.64 to 6.08 days.
  • Time to oral fluid intake reduced from 4.36 to 1 postoperative day.
  • Time to regular diet shortened from 6.14 to 3.23 postoperative days, with a significant reduction in TPN duration from 5.14 to 1.69 days.

Conclusions:

  • Pediatric ERAS protocol implementation for reverse stoma surgery is safe and effective.
  • The protocol demonstrably reduces metabolic stress and enhances recovery outcomes in children.
  • Further research is warranted to fully elucidate the long-term benefits and optimize protocol elements.
Abstract

Keywords:
enhanced recovery after surgerylength of staypediatric surgerytotal parenteral nutrition

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