BACKGROUND: Structured care pathways optimising peri-operative care have been shown to significantly enhance post-operative recovery. We aim to determine if enhanced recovery after surgery (ERAS) principles could provide benefit for paediatric patients undergoing major colorectal resection for inflammatory bowel disease (IBD). METHODS: Children undergoing elective bowel resection for IBD at a regional paediatric unit using standard methods of peri-operative care were matched to adult cases from an associated tertiary referral university hospital already using an ERAS program. Cases were matched for disease type, gender, operative procedure, and ASA grade. RESULTS: Forty-four children undergoing fifty procedures were identified. Thirty-four were matched to adult cases. Total length of stay in the paediatric group was significantly longer than in the adult group (6 vs. 9 days; P=0.001). Paediatric patients were slower to start solid diet (1 vs. 4 days; P<0.0001) and were slower to mobilize post-operatively (1 vs. 4 days; P<0.0001). No difference was seen in time to restoration of bowel function (2 vs. 3 days; P=0.49). Thirty day readmissions and total in-hospital morbidity were not significantly different between the groups. CONCLUSION: Potentially, application of ERAS in paediatric surgery could accelerate recovery and reduce length of post-operative stay thereby improving quality and efficiency of care.
BACKGROUND: Structured care pathways optimising peri-operative care have been shown to significantly enhance post-operative recovery. We aim to determine if enhanced recovery after surgery (ERAS) principles could provide benefit for paediatric patients undergoing major colorectal resection for inflammatory bowel disease (IBD). METHODS:Children undergoing elective bowel resection for IBD at a regional paediatric unit using standard methods of peri-operative care were matched to adult cases from an associated tertiary referral university hospital already using an ERAS program. Cases were matched for disease type, gender, operative procedure, and ASA grade. RESULTS: Forty-four children undergoing fifty procedures were identified. Thirty-four were matched to adult cases. Total length of stay in the paediatric group was significantly longer than in the adult group (6 vs. 9 days; P=0.001). Paediatric patients were slower to start solid diet (1 vs. 4 days; P<0.0001) and were slower to mobilize post-operatively (1 vs. 4 days; P<0.0001). No difference was seen in time to restoration of bowel function (2 vs. 3 days; P=0.49). Thirty day readmissions and total in-hospital morbidity were not significantly different between the groups. CONCLUSION: Potentially, application of ERAS in paediatric surgery could accelerate recovery and reduce length of post-operative stay thereby improving quality and efficiency of care.
Authors: Jonathan Vacek; Teaniese Davis; Benjamin T Many; Sharron Close; Sarah Blake; Yue-Yung Hu; Jane L Holl; Julie Johnson; Jennifer Strople; Mehul V Raval Journal: J Pediatr Surg Date: 2020-06-27 Impact factor: 2.545
Authors: Jinhua Feng; Ka Li; Li Li; Xiaodong Wang; Mingjun Huang; Jie Yang; Yanjie Hu Journal: Int J Colorectal Dis Date: 2016-08-12 Impact factor: 2.571
Authors: Cristen N Litz; Sandra M Farach; Allison M Fernandez; Richard Elliott; Jenny Dolan; Will Nelson; Nebbie E Walford; Christopher Snyder; Jeffrey P Jacobs; Ernest K Amankwah; Paul D Danielson; Nicole M Chandler Journal: Pediatr Surg Int Date: 2017-08-29 Impact factor: 1.827
Authors: Ira L Leeds; Emily F Boss; Jessica A George; Valerie Strockbine; Elizabeth C Wick; Eric B Jelin Journal: J Pediatr Surg Date: 2016-09-05 Impact factor: 2.545