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Enhanced recovery protocol for congenital duodenal obstruction - initial experiences with development and
Henrik Røkkum1,2, Martin Alavi Treider3,4, Wenche Bakken Børke5
1Department of Pediatric Surgery, Oslo University Hospital, Nydalen, P. O. Box 4950, N-0424, Oslo, Norway. henrik.rokkum@ous-hf.no.
Pediatric Surgery International
|December 27, 2024
Summary
Enhanced Recovery Protocols (ERPs) for neonatal congenital duodenal obstruction (CDO) surgery are novel. Implementing an ERP for CDO reduced feeding times and increased minimally invasive surgery use without complications.
Area of Science:
- Neonatal Surgery
- Surgical Protocols
- Pediatric Gastroenterology
Background:
- Limited experience exists with Enhanced Recovery After Surgery (ERAS) protocols in neonatal intestinal surgery.
- Congenital duodenal obstruction (CDO) is a condition requiring surgical intervention in neonates.
- Standardized perioperative care pathways for neonatal CDO are not well-established.
Purpose of the Study:
- To develop and implement a specialized Enhanced Recovery Protocol (ERP) for neonates with CDO.
- To describe the process of ERP development and implementation in this specific population.
- To evaluate the early clinical outcomes following the implementation of the CDO-ERP.
Main Methods:
- A multidisciplinary team developed and implemented an ERP tailored for CDO.
- Stakeholder involvement was crucial in the ERP design process.
- Clinical outcomes of neonates treated before (2015-2020) and after (2022-2024) ERP implementation were compared.
Main Results:
- Successful implementation achieved 80% ERP compliance in 21 patients post-implementation.
- Compared to 40 patients pre-ERP, the post-implementation group showed increased minimally invasive surgery use.
- Time to first postoperative enteral and breast feeds was significantly reduced without an increase in complications.
Conclusions:
- An ERP specifically designed for congenital duodenal obstruction is feasible and safe in neonates.
- The study provides a unique account of the development and implementation of such a protocol.
- Early outcomes indicate potential benefits in recovery and surgical approach for neonatal CDO.
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