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An enhanced recovery after surgery pathway in pediatric colorectal surgery improves patient outcomes

Laura N Purcell1, Kathleen Marulanda1, Matthew Egberg2

  • 1Department of Surgery, University of North Carolina at Chapel Hill, NC.

Journal of Pediatric Surgery
|November 2, 2020
PubMed

Insights

Enhanced recovery after surgery (ERAS) pathways significantly reduce opioid use, length of stay, and time to oral intake in pediatric colorectal surgery patients. These findings support the integration of ERAS protocols for improved pediatric surgical care.

Area of Science:

  • Pediatric Surgery
  • Enhanced Recovery After Surgery (ERAS)
  • Colorectal Surgery

Background:

  • Enhanced Recovery After Surgery (ERAS) pathways are established for adult colorectal surgery, improving outcomes.
  • Limited data exists on ERAS pathway efficacy in pediatric colorectal surgery.

Purpose of the Study:

  • To evaluate the impact of ERAS pathway implementation on pediatric colorectal surgery outcomes.
  • To assess reductions in opioid utilization, length of stay, and time to oral intake.

Main Methods:

  • Retrospective cohort study of pediatric patients (2-18 years) from 2014-2018.
  • Comparison of pre- and post-ERAS pathway implementation groups.
  • Bivariate analysis and linear regression to determine ERAS impact on MME/kg, LOS, and oral intake.

Main Results:

  • ERAS pathway implementation led to significant reductions in total morphine milligram equivalents per kilogram (MME/kg), Foley catheter duration, time to oral intake, and length of stay (LOS).
  • No increase in complications was observed in the ERAS cohort.
  • ERAS pathway use was independently associated with reduced MME/kg (-0.071, 95% CI -0.10 to -0.043).

Conclusions:

  • ERAS pathways effectively decrease opioid consumption in pediatric colorectal surgery.
  • Reduced opioid use correlates with shorter LOS and faster oral intake initiation.
  • Incorporating ERAS pathways into pediatric colorectal surgery care is recommended.
Abstract

Keywords:
ERASERAS in colorectal surgeryEnhanced recoveryPediatric surgery

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