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Enhanced recovery after urological reconstructive surgery in pediatric patients: a systematic review and

Fabiola Cassaro1,2, Pietro Impellizzeri1, Giulia Maisano1

  • 1Unit of Pediatric Surgery, Department of Human Pathology of Adult and Childhood "Gaetano Barresi", University of Messina, 98125, Messina, Italy.

Pediatric Surgery International
|April 9, 2025
PubMed

Insights

Enhanced Recovery After Surgery (ERAS) protocols significantly reduce complications and hospital stays in pediatric urological reconstructive surgery. This evidence supports standardizing ERAS for improved pediatric surgical outcomes.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Surgical Protocols

Background:

  • Enhanced Recovery After Surgery (ERAS) protocols minimize surgical stress and shorten recovery.
  • Previous studies indicated ERAS effectiveness in pediatric gastrointestinal surgery.
  • The application of ERAS in pediatric urological reconstructive surgery requires further evaluation.

Purpose of the Study:

  • To systematically review and meta-analyze the benefits of ERAS protocols in pediatric urological reconstructive surgery.
  • To compare ERAS with traditional protocols regarding patient outcomes.
  • To assess the safety and feasibility of ERAS in this specific pediatric surgical population.

Main Methods:

  • Systematic literature search on PubMed for studies comparing ERAS and traditional protocols.
  • Meta-analysis of data including major/minor complications, hospital readmission, and length of stay.
  • Statistical analysis using Odds Ratios (OR) with 95% Confidence Intervals (Cl), with p < 0.05 considered significant.

Main Results:

  • 10 studies with 1410 patients (492 ERAS, 918 No-ERAS) were included.
  • ERAS significantly reduced major complications (p < 0.001) and length of hospital stay (p < 0.001).
  • ERAS also decreased the incidence of minor complications (p = 0.002) without affecting hospital readmission rates (p = 0.763).

Conclusions:

  • The ERAS protocol is safe and feasible for pediatric reconstructive urological surgery.
  • ERAS implementation leads to reduced complication risks and shorter hospital stays.
  • Standardizing ERAS procedures in pediatric reconstructive urology is recommended.

Keywords:
ERASEnhanced recovery after surgeryFast track surgeryPediatric surgeryPediatric urologyUrological reconstructive surgery

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