Enhanced Recovery Care versus Traditional Care after Surgery in Pediatric Patients with Inflammatory Bowel Disease: A Retrospective Case-Control Study

Abstract

This study reports the outcomes of an enhanced recovery after surgery (ERAS) protocol in pediatric inflammatory bowel disease (IBD) surgery. Children who underwent surgery for IBD at two academic referral centers from January 2016 to June 2021 were included. Preoperative counseling, early enteral feeding (Impact®, Nestlé Health Science, and early mobilization were all part of the ERAS protocol. The outcomes (timing of first defecation, postoperative complications, and length of hospital stay (LOS)) were compared to traditional perioperative regimens (non-ERAS group). Thirty-three children who had 61 abdominal surgeries for IBD were included. Forty (65.5%) surgical procedures were included in the non-ERAS group, and 21 (34.5%) were included in the ERAS group. The postoperative complication rate was significantly lower in the ERAS group than in the non-ERAS group (29.6% vs. 55%, p = 0.049). The first defecation occurred earlier in the ERAS group than in the non-ERAS group (p < 0.001). There was no significant intergroup difference in the LOS. The implementation of ERAS in pediatric IBD surgery resulted in better outcomes than traditional perioperative care, especially in terms of postoperative complication rate and bowel function recovery. Further pediatric studies are needed to validate these findings and support ERAS application in children.

Editorial: Novel Therapeutic Approaches in Inflammatory Bowel Diseases

“…Huguet et al indicated that the subcutaneous formulation of Infliximab (CT-P13) achieved higher drug levels, less immunogenicity, better perianal disease control, and improved mucosal healing compared to intravenous Infliximab [ 9 ]. Dipasquale and colleagues demonstrated that the enhanced recovery after surgery (ERAS) protocol significantly reduced postoperative complication rates and the timing of first defecation compared to traditional perioperative regimens, suggesting its superiority [ 10 ]. Finally, Papa et al investigated the impact of SARS-CoV-2 infection on the course of IBDs in patients treated with biological agents, revealing that SARS-CoV-2 infection did not increase IBD recurrence rates in this patient cohort [ 11 ].…”