An enhanced recovery after surgery pathway in pediatric colorectal surgery improves patient outcomes
| Autor: | Nicole Chaumont, Peggy McNaull, Concetta Lupa, Sean E. McLean, Matthew D. Egberg, Timothy S. Sadiq, Andrea Hayes-Jordan, Laura N. Purcell, Sabrina Mangat, Michael R. Phillips, Kathleen Marulanda, Christopher J McCauley |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Statistical difference 03 medical and health sciences Postoperative Complications 0302 clinical medicine Enhanced recovery 030225 pediatrics Internal medicine Pediatric surgery Humans Medicine Child Enhanced recovery after surgery Digestive System Surgical Procedures Retrospective Studies business.industry Retrospective cohort study General Medicine Length of Stay Colorectal surgery 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Cohort Surgery Level iii Enhanced Recovery After Surgery business Colorectal Surgery |
| Zdroj: | Journal of Pediatric Surgery. 56:115-120 |
| ISSN: | 0022-3468 |
| Popis: | Introduction Enhanced recovery after surgery (ERAS) pathways in adult colorectal surgery are known to reduce complications, readmissions, and length of stay (LOS). However, there is a paucity of ERAS data for pediatric colorectal surgery. Methods A 2014–2018 single-institution, retrospective cohort study was performed on pediatric colorectal surgery patients (2–18 years) pre- and post-ERAS pathway implementation. Bivariate analysis and linear regression were used to determine if ERAS pathway implementation reduced total morphine milligram equivalents per kilogram (MME/kg), LOS, and time to oral intake. Results 98 (70.5%) and 41 (29.5%) patients were managed with ERAS and non-ERAS pathways, respectively. There was no statistical difference in age, sex, diagnosis, or use of laparoscopic technique between cohorts. The ERAS cohort experienced a significant reduction in total MME/kg, Foley duration, time to oral intake, and LOS with no increase in complications. The presence of an ERAS pathway reduced the total MME/kg (− 0.071, 95% CI − 0.10, − 0.043) when controlling for covariates. Conclusion The use of an ERAS pathway reduces opioid utilization, which is associated with a reduction in LOS and expedites the initiation of oral intake, in colorectal pediatric surgery patients. Pediatric ERAS pathways should be incorporated into the care of pediatric patients undergoing colorectal surgery. Level of evidence Level III evidence. Type of study Retrospective cohort study. |
| Databáze: | OpenAIRE |
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