Purpose <p>Implementation of Enhanced Recovery After Surgery (ERAS) protocols in paediatric surgery remains limited, despite proven benefits in adults. The barriers to implementation and protocol modifications requires comprehensive detailing in paediatrics. We aimed to determine the practicality and safety of ERAS in paediatric laparoscopies at a tertiary-care center, addressing the context-specific barriers.</p> Methods <p>This was a prospective, single-arm, preliminary study. One hundred thirty-six children, aged 2–14 years, undergoing laparoscopy were enrolled. ERAS elements were implemented perioperatively. The outcomes analysed included protocol compliance, length of hospital stay (LOS), 30-day complications, readmission and mortality rates. The challenges to implementation were noted.</p> Results <p>Overall protocol compliance was 82.5 ± 12.4%. There was a significant correlation between adherence to components and LOS (<i>r=-0.642 ; p &lt; 0.01</i>). Time to start liquids/solids and drain removal showed a significant correlation with LOS. No complications and 30-day readmissions were directly attributable to the fast-track concepts. There was no mortality. Key challenges included infrastructure, parental anxiety regarding early discharge and persistently motivating stakeholders to adhere the protocol.</p> Conclusion <p>Implementing paediatric ERAS protocol is safe and feasible within a tertiary health-setting. A high degree of multidisciplinary commitment can successfully overcome the unique logistic and cultural barriers with an accelerated convalescence.</p>

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Implementation of enhanced recovery after surgery (ERAS) protocols for paediatric laparoscopic surgery: a single-center experience

  • Shreya Shah,
  • Rashmi Ramachandran,
  • Vishesh Jain,
  • Anjan Dhua,
  • Rajeshwari Subramaniam,
  • Parmeet Kaur,
  • Vimi Rewari

摘要

Purpose

Implementation of Enhanced Recovery After Surgery (ERAS) protocols in paediatric surgery remains limited, despite proven benefits in adults. The barriers to implementation and protocol modifications requires comprehensive detailing in paediatrics. We aimed to determine the practicality and safety of ERAS in paediatric laparoscopies at a tertiary-care center, addressing the context-specific barriers.

Methods

This was a prospective, single-arm, preliminary study. One hundred thirty-six children, aged 2–14 years, undergoing laparoscopy were enrolled. ERAS elements were implemented perioperatively. The outcomes analysed included protocol compliance, length of hospital stay (LOS), 30-day complications, readmission and mortality rates. The challenges to implementation were noted.

Results

Overall protocol compliance was 82.5 ± 12.4%. There was a significant correlation between adherence to components and LOS (r=-0.642 ; p < 0.01). Time to start liquids/solids and drain removal showed a significant correlation with LOS. No complications and 30-day readmissions were directly attributable to the fast-track concepts. There was no mortality. Key challenges included infrastructure, parental anxiety regarding early discharge and persistently motivating stakeholders to adhere the protocol.

Conclusion

Implementing paediatric ERAS protocol is safe and feasible within a tertiary health-setting. A high degree of multidisciplinary commitment can successfully overcome the unique logistic and cultural barriers with an accelerated convalescence.