# Enhanced Recovery After Surgery (ERAS) Improves Length of Stay and Decreases Complications After Resection of Abdominal Neuroblastoma — GCMD Library Sara A Mansfield, Meera Kotagal, Stephen J Hartman, Andrew J Murphy, Brady Hogan, Darren Ha, Doralina L Anghelescu, Marc Mecoli, Nicholas G Cost, Andrew M Davidoff, Kyle O Rove

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 resection of abdominal neuroblastoma. Children with neuroblastoma stand to benefit considerably from the benefits associated with the use of an ERAS protocol, given their intensive treatment, complex surgeries, and need for expeditious recovery.
Type: video · 1 min · posted 2026-02-16 Canonical: https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522 ## Chapters - [0:00](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=0) ERAS Protocol for Neuroblastoma Resection ## Statements - "A multi-center prospective study evaluated a structured ERAS pathway for children undergoing abdominal neuroblastoma resection" — Sophia Schermerhorn (clinical) [0:03](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=3) - "The ERAS protocol included 20 evidence-based elements spanning the entire perioperative process" — Sophia Schermerhorn (clinical) [0:13](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=13) - "ERAS protocol elements included preoperative counseling, hydrate loading, standardized multimodal analgesia, early feeding, and early mobilization" — Sophia Schermerhorn (clinical) [0:13](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=13) - "Length of stay decreased from about 7 days to 3.7 days" — Sophia Schermerhorn (clinical) [0:28](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=28) - "Post-operative opioid use dropped by over half" — Sophia Schermerhorn (clinical) [0:32](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=32) - "Patients resumed regular diets and ambulated about 3 days earlier" — Sophia Schermerhorn (clinical) [0:32](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=32) - "The proportion of patients experiencing any postoperative complication decreased by over 50%" — Sophia Schermerhorn (clinical) [0:39](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=39) - "Patients were cleared to resume adjuvant chemotherapy earlier at around 8 days as opposed to 10 days" — Sophia Schermerhorn (clinical) [0:46](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=46) - "A structured ERAS pathway meaningfully improves recovery even after complex neuroblastoma resections" — Sophia Schermerhorn (opinion) [0:51](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=51) - "ERAS represents a tangible opportunity to standardize perioperative care for neuroblastoma resection" — Sophia Schermerhorn (opinion) [0:51](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=51) ## Transcript Did you know there's an ERAS protocol for neuroblastoma? Hi, I'm Doctor Sophia Schermerhorn from Cincinnati Children's, and this multi-center prospective study evaluated a structured ERAS pathway for children undergoing abdominal neuroblastoma resection. This ERAS protocol included 20 evidence-based elements spanning the entire perioperative process, from things like preoperative counseling. Hydrate loading, standardized multimodal analgesia, early feeding, and early mobilization. The results were striking. Length of stay decreased from about 7 days to 3.7 days. Post-operative opioid use dropped by over half, and patients resume regular diets and ambulated about 3 days earlier. Most notably, the proportion of patients experience. any postoperative complication decreased by over 50% as well. Patients were also cleared to resume adjuvant chemotherapy earlier at around 8 days and opposed to 10 days. The takeaway is that a structured ERAS pathway meaningfully improves recovery, even after complex neuroblastoma resections, and represents a tangible opportunity to standardize perioperative care. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai