Enhancing recovery after minimally invasive surgery (MIS) in children | 44 years | 9 STUDIES were included. | 531 PATIENTS | Systematic review of studies reporting on enhancing recovery after surgery (ERAS) after MIS in children. | Laparoscopic surgery: GI | Urology | Thoracoscopy | Mean length of stay in the hospital | was decreased in ERAS children by | -1.12 days | No difference in complication rates between ERAS children and controls | 30 Day Readmission Rate | 4% ERAS vs 10% Control | Conclusion: ERAS after MIS in children may: | Decrease LOS and 30 day readmission rate with no difference in post-op complications. | https://pubmed.ncbi.nlm.nih.gov/34030881/ | Source: Dagorno C et al. | Department of Pediatric Surgery and Urology, Paris, France | @StayCurrentMD | @EmTombash @emencisco @RodGerardo
Enhancing recovery after minimally invasive surgery in children
Infographic · Feb 2022 · 1 min read
In brief
In brief
Systematic review of 9 studies involving 531 pediatric patients demonstrates that ERAS protocols after minimally invasive surgery reduce hospital length of stay by 1.12 days and decrease 30-day readmission rates without increasing complications. Evidence supports safe implementation of ERAS in pediatric laparoscopic and thoracoscopic procedures.
- ERAS protocols after pediatric MIS reduce hospital stay by 1.12 days without increasing complication rates
- 30-day readmission rates decreased from 10% to 4% in children following ERAS protocols after minimally invasive surgery
- ERAS implementation is safe in pediatric laparoscopic and thoracoscopic procedures across digestive and urologic surgeries
- Evidence for pediatric ERAS remains limited with only 9 studies (531 patients) meeting systematic review criteria
- ERAS protocols can be safely adapted from adult surgery to pediatric minimally invasive procedures
Written by the GCMD Library team from the infographic.
A teal and yellow infographic divided into sections with icons including a calendar, cartoon children, a hospital bed, and a clipboard-holding clinician. Key statistics are displayed in large bold text with supporting details in smaller fonts. The layout flows from top to bottom with a conclusion box in yellow on the right side.
Objective: Enhanced recovery after surgery (ERAS) has been widely implemented after minimally invasive surgeries (MIS) in adults. The aim of this study was to evaluate the current evidence available on ERAS after MIS in children.
Methods: Using a defined search strategy (PubMed, Cochrane, Scopus), we performed a systematic review of the literature, searching for studies reporting on ERAS after MIS (thoracoscopy, laparoscopy, retroperi- toneoscopy) in children (1975–2019). This study was registered with PROSPERO-international prospective register of systematic reviews. A meta-analysis was conducted using comparative studies for length of stay (LOS), complication rates, and readmission rates.
Results: Of 180 abstracts screened, 20 full-text articles were analyzed, and 9 were included in our system- atic review (1 randomized controlled trial, 3 prospective, and 5 retrospective studies), involving a total number of 531 patients. ERAS has been applied to laparoscopy for digestive ( n = 7 studies) or urologic surgeries ( n = 1), as well as thoracoscopy ( n = 1). Mean LOS was decreased in ERAS children compared to controls (6 studies, −1.12 days, 95%IC: −1.5 to −0.82, p < 0.0 0 0 01). There was no difference in com- plication rates between ERAS children and control children (5 studies, 13% vs 14%, OR = 0.84, 95%CI: 0.49–1.44, p = 0.52). The 30-day readmission rate was decreased in ERAS children compared to controls (6 studies, 4% vs 10%, OR = 0.34, 95%CI: 0.18–0.66, p = 0.001).
Conclusions: Although the evidence regarding ERAS in MIS is scarce, these protocols seem safe and ef- fective, by decreasing LOS and 30-day readmission rate, without increasing post-operative complication rates.