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Enhanced Recovery After Surgery for Pediatric Abdominal Tumor Resections: A Prospective Multi-institution Study
Sara A Mansfield1, Meera Kotagal2, Stephen J Hartman2
1Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA; Division of Pediatric Surgery, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
Journal of Pediatric Surgery
|November 9, 2024
Summary
Enhanced Recovery After Surgery (ERAS) protocols are feasible for pediatric abdominal tumor resections. ERAS significantly reduced complications, opioid use, and improved recovery times in children.
Area of Science:
- Pediatric Surgery
- Oncology
- Enhanced Recovery After Surgery Protocols
Background:
- Enhanced Recovery After Surgery (ERAS) protocols standardize perioperative care.
- This study is the first prospective, multi-institutional evaluation of ERAS in pediatric patients undergoing abdominal tumor resections.
Purpose of the Study:
- To evaluate the feasibility and impact of ERAS protocols in pediatric patients undergoing abdominal tumor resections.
Main Methods:
- A prospective cohort of pediatric patients (>1 month old) undergoing abdominal tumor resection were enrolled between 2020-2022.
- ERAS protocol was standardized across three institutions.
- Compared to a propensity-matched historical cohort (2014-2020) using 16 variables.
Main Results:
- ERAS cohort (95 patients) showed a trend towards shorter median length of stay (LOS) (4.3 days) compared to the historic cohort (5.3 days).
- Post-operative opioid consumption was significantly lower in the ERAS cohort (p=0.013).
- ERAS patients experienced significantly fewer complications (44.2% vs 86.3%, p<0.001), earlier diet advancement, and faster ambulation.
Conclusions:
- ERAS protocols are feasible and safe for pediatric patients undergoing abdominal tumor resections.
- Implementation of ERAS significantly reduced complications, opioid consumption, and accelerated recovery.
- ERAS protocols represent a valuable approach to optimizing care for pediatric surgical oncology patients.
