Modified Enhanced Recovery After Surgery Protocols in Pediatric Gastric Transposition: Effects on Recovery and...

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery
• Critical Care Medicine

Background:

• Enhanced Recovery After Surgery (ERAS®) protocols optimize surgical patient recovery.
• Application of ERAS® in pediatric esophageal replacement, specifically gastric transposition, is limited.
• Modified ERAS® (mERAS®) protocols may enhance outcomes in this population.

Purpose of the Study:

• To assess the outcomes of pediatric patients undergoing gastric transposition using a modified ERAS® (mERAS®) protocol.
• To compare outcomes between patients managed with mERAS® and a conventional approach.
• To evaluate the impact of mERAS® on recovery metrics and quality of life.

Main Methods:

• Retrospective and prospective cohort study of pediatric patients undergoing gastric transposition for long-gap Esophageal atresia/Tracheo-esophageal fistula (EA/TEF).
• Comparison of outcomes between a conventional non-ERAS® group and a prospective mERAS® group.
• Quality of life assessment using QUALIN and Depression, Anxiety, and Stress Scale scores; statistical analysis via Chi-square/Fisher's exact and Wilcoxon rank-sum tests.

Main Results:

• High compliance with the mERAS® protocol was observed.
• The mERAS® group demonstrated statistically significant reductions in ventilation duration (2.08 vs. 6.43 days), ICU stay (8.82 vs. 21.08 days), and earlier feeding initiation (2.75 vs. 7.15 days).
• Shorter hospital stay (16.25 vs. 26.07 days) and significant improvements in infant quality of life and parental satisfaction were noted in the mERAS® group.

Conclusions:

• Implementation of mERAS® protocols in pediatric gastric transposition surgery accelerates recovery.
• mERAS® leads to shorter hospitalizations and improved infant quality of life.
• The mERAS® approach enhances parental satisfaction following complex esophageal replacement surgery.