Implementation of Enhanced Recovery After Surgery protocols for gastrostomy tube insertion in patients younger than 14 years of age: a retrospective cohort study

Abstract

BACKGROUND: Enhanced recovery after surgery (ERAS) protocols have improved treatment outcomes and have standardized patient care. OBJECTIVES: Identify the benefit of introducing the ERAS protocol for feeding after gastrostomy insertion with or without Nissen fundoplication, the effects on the time of reaching the full feeds the length of stay single-center experience, and complications associated with early feeding protocols. DESIGN: Retrospective cohort study SETTING: Tertiary hospital METHODS: The study review included cases performed between 2015 and 2021 by four surgeons, and cases performed in 2022 by all surgeons using ERAS feeding protocol (P) in a tertiary hospital. MAIN OUTCOME MEASURES: Comparison the mean and mode of the length of stay (LOS) and the time until the patient reached full feed (TFF). SAMPLE SIZE: 224 patients; 181 by the four surgeons and 43 cases by the ERAS protocol group. RESULTS: The difference in the ERAS protocol from the four surgeons in TFF and LOS was statistically significant ( P <.001). There was no noticeable difference in postoperative complications after introducing the ERAS protocol. CONCLUSION: ERAS improved the TFF and decreased the LOS without any increase in procedure complications. Increasing bed utilization and reducing costs were two benefits of reducing LOS at our hospital. LIMITATIONS: Single-center study, which may not be generalizable. Multiple comorbidities. Travel time from different parts of the country could impact LOS. Retrospective and thus dependent on the accuracy of the information in file notes. CONFLICT OF INTEREST: None.

Enhanced Recovery After Surgery (ERAS) in Saudi Arabian Surgical Practice: A Comprehensive Analysis of Surgical Outcomes, Patient Satisfaction, and Cost-Effectiveness

“…This outcome emphasizes that ERAS protocols, with their focus on patient engagement, preoperative education, and comprehensive perioperative care, have the potential to enhance not only physical recovery but also the psychological and emotional well-being of surgical patients. The international literature consistently supports the notion that ERAS protocols lead to higher levels of patient satisfaction [ 20 - 22 ].…”

“…Self-reported data, while valuable, can be subject to response and recall bias. Addressing these limitations through more robust study designs, larger sample sizes, and varied data sources can enhance the validity of future research [13][14][15][16][17][18][19][20][21][22].…”

“…Ultimately, the adoption of ERAS protocols in Saudi Arabia and other Middle Eastern countries has the potential to significantly improve surgical care and enhance patient experiences. This research serves as a crucial stepping stone in that direction [13][14][15][16][17][18][19][20][21][22].…”