Enhanced recovery protocols versus traditional methods after resection and reanastomosis in gastrointestinal surgery in pediatric patients

Fathy, Mohamed; Khedre, Mohamed M.; Nagaty, Mohamed A.M.; Zaghloul, Naser

doi:10.1097/01.xps.0000544636.85711

Cited by 6 publications

(13 citation statements)

References 11 publications

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“…There was no significant difference in the pain scores after surgery between the two groups in the current study, even though previous research has demonstrated significant improvements in pain after surgery due to the implementation of ERAS protocols; 16 and other studies have shown less postoperative opioid use. 6,17,18 This current study found no relationship between ERAS protocol implementation and postoperative complication rates represented by ER visits, readmissions within 30 days and reoperations within 90 days, in contrast to previous studies that showed significantly lower complication rates both during the hospitalization period and after discharge when using ERAS protocols, 10,13,19 while others showed no difference in ED visits and readmissions before and after implementing ERAS protocols. 6 The failure to show significant differences between the two groups in terms of postoperative complications might be due to the fact that patients undergoing open appendectomies usually receive some elements of enhanced recovery, in addition to the fact that most open surgeries are undertaken using small incisions.…”

Section: Discussioncontrasting

confidence: 99%

“…6 However, an Egyptian study that compared the results of implementing enhanced recovery involving no routine drains after GI resection and anastomosis surgeries versus the traditional methods, reported a significantly shorter postoperative hospital stay in the enhanced recovery group. 13 The majority of patients (44 of 55 patients; 80.0%) in group 2 had their first oral intake of nutrition within the first 24 h, which might have contributed to their earlier discharge from hospital. These findings were similar to a previous study that demonstrated that patients who received oral nutrition immediately after their GI operation had a significantly decreased length of hospital stay in comparison to oral nutrition initiated later.…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Enhanced recovery concepts in paediatric patients who underwent appendectomy: a retrospective cohort study at a tertiary university hospital

et al. 2023

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Objective To investigate if the implementation of enhanced recovery after surgery (ERAS) pathways could be effective in paediatric patients undergoing appendectomy. Methods This retrospective study analysed the data from patients aged ≤18 years that underwent appendectomies. The data collected included age, sex, application of enhanced recovery concepts (ERCs) and clinical outcomes. Results A total of 93 paediatric patients were retrospectively categorized into two groups: patients in group 1 did not experience the use of ERCs during their appendectomies; and patients in group 2 had ERCs applied during their appendectomies. Patients in both groups were exposed to some elements of ERAS, including preoperative patient/parent counselling, limited fasting durations, antibiotic prophylaxis and no bowel preparations. Duration of hospital stay was significantly longer in group 1 compared with group 2 (3.47 ± 1.81 days versus 2.24 ± 1.52 days, respectively. There were no significant differences between the two groups in term of postoperative pain control, hospital cost, readmissions, reoperations and emergency room visits. Conclusion Implementing ERCs in paediatric patients undergoing appendectomies provided a significant improvement in patient recovery with a shorter hospital stay, with no increase in postoperative pain, hospital cost, rate of readmission and reoperation.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 97%

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Enhanced recovery concepts in paediatric patients who underwent appendectomy: a retrospective cohort study at a tertiary university hospital

et al. 2023

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“…The best result of finding is zero wound dehiscence in those patients with regular feeding group and 3.3% in patients receiving no sooner oral feeding. This result is relatively similar to Masood A et al (18) in their study the burst abdomen was seen in one patient (2.8%) in the early postoperative feeding group.…”

Section: Discussionsupporting

confidence: 91%

Early Enteral Feeding Versus Delayed Enteral Nutrition: Effects On Morbidity After Intestinal Surgery; A Prospective Study

Abed¹

2022

Journal of Pharmaceutical Negative Results

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Routine practice after bowel anastomoses has been to keep patient nil per oral till the return of bowel sound with a belief that this will prevent postoperative nausea and vomiting and protect the anastomotic site where, however this trend had been changed to encourage enteral feeding as early as possible as various studies has shown early enteral feeding to be beneficial in terms of nutritional, immunological aspect and for faster postoperative recovery of patient. Objective; To study and compare the effects of early enteral feeding with those of conventional management in postoperative patients undergoing intestinal primary suturing or direct repair. Patients and methods ; A prospective interventional study conducted for 135 patients with an age range between 15 – 67 years old who admitted to the general surgery Department in AlKindy Teaching Hospital, Baghdad, Iraq for the period between 1st of March 2019 and 1st October 2021. The patients were randomly assigned to schedule with starting oral feeding on the first day after surgery, referred to as early feeding group and those with delayed oral feeding till first passage of flatus and bowel movement, referred to as regular feeding group and compared overall prevalence of postoperative complication, length of hospital stay and outcome of surgery in these two groups. Result; There was less post operative complication in early feeding group as compaired with regular feeding group patients. Twenty percent patients developed post operative vomiting in early feeding group and sixteen percent patients in regular feeding group. Post operative fever occurred in five percent patients in early feeding group while sixteen percent patients in regular feeding group sufferd from postoperative fever. Abdominal distension noted in five percent patients in early feeding group while sixteen percent patients in regular feeding group. The average length of hospital stay in patient belong to early feeding group was 2-5 day while patient in regular feeding group stayed in hospital for average 3-8 days. Conclusion; There is more benefit from early oral feeding than delay oral feeding strategy in incidence of postoperative morbidity and period of hospital stay after intestinal surgery.

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“…However, data on outcomes associated with the use of FT protocol in paediatric populations are limited. [ 10 ] Although FT surgery has been used for some procedures in children, such as appendectomy,[ 11 12 13 14 ] nephrectomy, pyelolithotomy and pyeloplasty;[ 15 16 ] there is considerable component variability in the studies performed in this area, and none utilised all the components. [ 17 18 19 20 ] The aim of the study was to determine the post-operative complication rate and length of stay (in hospital) (LOS) after applying FT protocol in paediatric intestinal stoma closure and compare it with conventional perioperative care protocol.…”

Section: Introductionmentioning

confidence: 99%

Fast Track versus Conventional Perioperative Care Protocols in Paediatric Intestinal Stoma Closure [FIGURE DASH] A Randomised Study

Farhad,

Sarwar,

Chowdhury

et al. 2023

African Journal of Paediatric Surgery

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Background: It is still unclear to what extent fast-track (FT) surgery is applicable in paediatric surgery. The aim of the study was to compare the outcome between FT and conventional perioperative care protocols in paediatric intestinal stoma closure to assess the safety for future application. Materials and Methods: This study was a prospective randomised study. Twenty-six paediatric patients who underwent intestinal stoma closure from December 2019 to March 2021 were divided into two groups: group A, conventional methods and Group B FT protocol. The FT protocol included minimal pre-operative fasting, no pre-operative bowel preparation, no routine intraoperative use of nasogastric tube, drain tube, urinary catheter, early post-operative enteral feeding, early mobilisation, non-opioid analgesics and prophylactic use of anti-emetic. Total length of post-operative hospital stays and complications between these two groups were compared. Results: No significant differences were found between the two groups regarding anastomotic leak (nil in both groups), wound infection (7.7% in Group A vs. 0% in Group B; P = 1.0) and wound dehiscence (7.7% in Group A vs. 0% in Group B; P = 1.0). No significant differences were found in post-operative length of stay (median 5, interquartile range [IQR] 4–9 in Group A and median 6, IQR 4–7 in Group B, P = 0.549) and time to appearance of bowel function (passage of stool) (median 2 days in both groups; P = 0.978). Conclusions: FT surgery was comparable to the conventional method in terms of complication and thus can reduce unnecessary interventions.

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Enhanced recovery protocols versus traditional methods after resection and reanastomosis in gastrointestinal surgery in pediatric patients

Cited by 6 publications

References 11 publications

Enhanced recovery concepts in paediatric patients who underwent appendectomy: a retrospective cohort study at a tertiary university hospital

Enhanced recovery concepts in paediatric patients who underwent appendectomy: a retrospective cohort study at a tertiary university hospital

Early Enteral Feeding Versus Delayed Enteral Nutrition: Effects On Morbidity After Intestinal Surgery; A Prospective Study

Fast Track versus Conventional Perioperative Care Protocols in Paediatric Intestinal Stoma Closure [FIGURE DASH] A Randomised Study

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