Implementation of ERAS protocol in pediatric colostomy closure: a randomized clinical trial

Area of Science:

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

Background:

• Enhanced Recovery After Surgery (ERAS) is a multimodal approach to minimize surgical stress and optimize patient recovery.
• Its application in pediatric colorectal surgery, specifically for colostomy closure, requires further evaluation.

Purpose of the Study:

• To evaluate the impact of ERAS protocols on pediatric patients undergoing colostomy closure.
• To assess the effect of ERAS on length of hospital stay, oral feeding resumption, narcotic consumption, and complication rates.

Main Methods:

• A prospective, randomized clinical trial involving 77 pediatric patients undergoing colostomy closure.
• Patients were randomized into an ERAS group (ERASG) or a control group (CG).
• The ERAS protocol encompassed preoperative, intraoperative, and postoperative interventions.

Main Results:

• The ERAS group demonstrated a significantly shorter length of hospital stay (3.30 days vs. 6.43 days; p=0.002).
• ERAS implementation led to a significant reduction in the time to resuming a regular diet and average narcotic use.
• No significant differences were found in postoperative complications or one-month readmission rates between the groups.

Conclusions:

• ERAS protocols are feasible and safe for pediatric colostomy closure.
• ERAS significantly improves recovery outcomes, including reduced length of stay and narcotic consumption.
• The findings support the broader implementation of ERAS in pediatric colorectal surgery.