Implementation of an enhanced recovery protocol in pediatric colorectal surgery
| Autor: | Curtis Travers, Katelyn Burch, Heather L. Short, Mehul V. Raval, John C. Edney, Kurt F. Heiss, Claudia Venable |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent genetic structures Psychological intervention Single Center Patient Readmission behavioral disciplines and activities Perioperative Care Young Adult 03 medical and health sciences 0302 clinical medicine Clinical Protocols Outcome Assessment Health Care Pediatric surgery medicine Humans Young adult Child Digestive System Surgical Procedures Retrospective Studies Protocol (science) business.industry Retrospective cohort study General Medicine Evidence-based medicine Length of Stay Colorectal surgery Surgery Child Preschool 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Emergency medicine Female 030211 gastroenterology & hepatology business Colorectal Surgery psychological phenomena and processes |
| Zdroj: | Journal of Pediatric Surgery. 53:688-692 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2017.05.004 |
| Popis: | Enhanced recovery protocols (ERPs) have been shown to improve outcomes in adult surgical populations. Our purpose was to compare outcomes before and after implementation of an ERP in children undergoing elective colorectal surgery.A pediatric-specific colorectal ERP was developed and implemented at a single center starting in January 2015. A retrospective review was performed including 43 patients in the pre-ERP period (2012-2014) and 36 patients in the post-ERP period (2015-2016). Outcomes of interest included number of ERP interventions received, length of stay (LOS), complications, and readmissions.The median number of ERP interventions received per patient increased from 5 to 11 from 2012 to 2016. The median LOS decreased from 5days to 3days in the post-ERP period (p=0.01). We observed a simultaneous decrease in median time to regular diet, mean dose of narcotics, and mean volume of intraoperative fluids (p0.001). The complication rate (21% vs. 17%, p=0.85) and 30-day readmission rate (23% vs. 11%, p=0.63) were not significantly different in the pre- and post-ERP periods.Implementation of a pediatric-specific ERP in children undergoing colorectal surgery is feasible, safe and may lead to improved outcomes. Further experience may highlight other opportunities for increased compliance and improved care.Treatment Study. Level III. |
| Databáze: | OpenAIRE |
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