Enhanced Recovery After Surgery (ERAS) Improves Length of Stay and Decreases Complications After Resection of Abdominal Neuroblastoma

Part of Pediatric Surgical Oncology 27 items

pubmed.ncbi.nlm.nih.gov

Meera Kotagal

Background: Enhanced recovery after surgery (ERAS) pathways are multidisciplinary strategies to return patients to their physiologic baseline as efficiently as possible. This study aims to evaluate the feasibility and benefits of an ERAS pathway in children undergoing resection of abdominal neuroblastoma. Methods: After IRB approval, all patients greater than 1 month old undergoing resection of an abdominal neuroblastoma at one of three children's hospitals between 2020 and 2022 were offered enrollment. A standardized ERAS protocol was utilized at all institutions. Data were prospectively recorded. We compared the prospective cohort to a historic cohort (2014-2020). Fisher's exact and t-tests were used, as appropriate. Results: The study included 23 patients in the ERAS group compared to 24 historic patients. Post-operative nasogastric tube use decreased from 91.7% pre-ERAS to 16.7% in the ERAS cohort. ERAS patients were advanced to regular diets and ambulated 3 days earlier than pre-ERAS. Post-operative opioid consumption decreased from 0.54 to 0.21 milligram morphine equivalents (MME) mg/kg/day (p = 0.047). All but one patient (23, 96%) in the pre-ERAS cohort experienced at least one post-operative complication, compared to only nine (39.1%) in the ERAS cohort (p < 0.001). Average length of stay was 3.7 days with ERAS compared to 6.9 days pre-ERAS (p = 0.004). Discussion: ERAS is associated with improvements in length of stay and a decrease in complications following resect

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Article · Aug 2025 · 1 min read

In brief

Multi-center study demonstrates that ERAS protocols in pediatric neuroblastoma resection reduce hospital stay from 6.9 to 3.7 days and decrease complication rates from 96% to 39%. The pathway also significantly reduced opioid consumption and enabled earlier diet advancement and ambulation compared to traditional care.

Written by the GCMD Library team from the article.

Meera Kotagal

Statements in this article

Enhanced recovery after surgery (ERAS) pathways are multidisciplinary strategies to return patients to their physiologic baseline as efficiently as possible.
EstablishedBackground
A standardized ERAS protocol was utilized at all three participating institutions for children greater than 1 month old undergoing resection of abdominal neuroblastoma.
RecommendationMethods
Post-operative nasogastric tube use decreased from 91.7% in the pre-ERAS cohort to 16.7% in the ERAS cohort.
ResearchResults
ERAS patients were advanced to regular diets 3 days earlier than pre-ERAS patients.
ResearchResults
ERAS patients ambulated 3 days earlier than pre-ERAS patients.
ResearchResults
Post-operative opioid consumption decreased from 0.54 to 0.21 milligram morphine equivalents (MME) mg/kg/day with ERAS implementation (p = 0.047).
ResearchResults
All but one patient (96%) in the pre-ERAS cohort experienced at least one post-operative complication, compared to only 39.1% in the ERAS cohort (p < 0.001).
ResearchResults
Average length of stay was 3.7 days with ERAS compared to 6.9 days pre-ERAS (p = 0.004).
ResearchResults
ERAS is associated with improvements in length of stay and a decrease in complications following resection of abdominal neuroblastoma.
ResearchDiscussion