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

Enhanced Recovery After Surgery (ERAS) is a multidisciplinary approach designed to minimize physiological stress and improve recovery. This study evaluated the impact of ERAS protocols on pediatric patients undergoing colostomy closure.

A prospective, randomized clinical trial was conducted at a tertiary center from May 2020 to July 2022. Seventy-seven pediatric patients admitted for colostomy closure were randomly assigned to the ERAS group (ERASG, n = 36) or the control group (CG, n = 41). The ERAS protocol included preoperative, intraoperative, and postoperative strategies to enhance outcomes. Primary outcomes included length of hospital stay (LOS), time to oral feeding, narcotic consumption, complications, and one-month readmission rates.

The mean LOS was significantly shorter in the ERASG (3.30 ± 0.95 days) compared to the CG (6.43 ± 3.80 days; p = 0.002). The ERASG showed a significant reduction in the median time to resuming a regular diet (p = 0.001) and average narcotic use (p = 0.015). No significant differences were observed in postoperative complications or readmission rates.

ERAS implementation in pediatric colostomy closure significantly reduced LOS, narcotic use, and time to oral feeding without increasing complications or readmissions, supporting its feasibility and safety in pediatric colorectal surgery.