Enhanced recovery after surgery in children undergoing abdominal surgery: meta-analysis

Journal article

AbstractBackground: Enhanced recovery after surgery (ERAS) is a multimodal approach that streamlines patient processes before, during, and after surgery. The goal is to reduce surgical stress responses and improve outcomes; however, the impact of ERAS programmes in paediatric abdominal surgery remains unclear. The authors aimed to review the effectiveness of ERAS on clinical outcomes in children undergoing abdominal surgery.Method: CINAHL, CENTRAL, Embase, ProQuest, PubMed, and Scopus were searched for relevant studies published from inception until January 2021. The length of hospital stay (LOS), time to oral intake, time to stool, complication rates, and 30-day readmissions were measured. Meta-analyses and subgroup analyses were conducted using RevMan 5.4 with a random-effects model.Results: Among 2371 records from the initial search, 111 articles were retrieved for full-text screening and 12 were included for analyses. The pooled mean difference (MD) demonstrated reduced LOS (MD −1.96; 95 per cent c.i. −2.75 to −1.17), time to oral intake (MD −3.37; 95 per cent c.i. −4.84 to −1.89), and time to stool (MD −4.19; 95 per cent c.i. −6.37 to −2.02). ERAS reduced postoperative complications by half and 30-day readmission by 36 per cent. Subgroup analyses for continuous outcomes suggested that ERAS was more effective in children than adolescents.Conclusion: ERAS was effective in improving clinical outcomes for paediatric patients undergoing abdominal surgery.Abstract Background: Enhanced recovery after surgery (ERAS) is a multimodal approach that streamlines patient processes before, during, and after surgery. The goal is to reduce surgical stress responses and improve outcomes; however, the impact of ERAS programmes in paediatric abdominal surgery remains unclear. The authors aimed to review the effectiveness of ERAS on clinical outcomes in children undergoing abdominal surgery. Method: CINAHL, CENTRAL, Embase, ProQuest, PubMed, and Scopus were searched for relevant studies published from inception until January 2021. The length of hospital stay (LOS), time to oral intake, time to stool, complication rates, and 30-day readmissions were measured. Meta-analyses and subgroup analyses were conducted using RevMan 5.4 with a random-effects model. Results: Among 2371 records from the initial search, 111 articles were retrieved for full-text screening and 12 were included for analyses. The pooled mean difference (MD) demonstrated reduced LOS (MD −1.96; 95 per cent c.i. −2.75 to −1.17), time to oral intake (MD −3.37; 95 per cent c.i. −4.84 to −1.89), and time to stool (MD −4.19; 95 per cent c.i. −6.37 to −2.02). ERAS reduced postoperative complications by half and 30-day readmission by 36 per cent. Subgroup analyses for continuous outcomes suggested that ERAS was more effective in children than adolescents. Conclusion: ERAS was effective in improving clinical outcomes for paediatric patients undergoing abdominal surgery

Authors: Hidayah, BA; Toh, ZA; Cheng, LJ; Syahzarin, BD; Zhu, Y

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Oxford University Press
• Journal: BJS Open
• Volume: 7
• Issue: 1
• Pages: zrac147
• Publication date: 2023-01-06
• DOI: 10.1093/bjsopen/zrac147
• EISSN: 2474-9842
• ISSN: 2474-9842
• Language: English
• Keywords: CINAHL; General surgery; Subgroup analysis; Colorectal surgery; Psychological intervention; Meta-analysis; Surgery; Medicine; MEDLINE; Abdominal surgery; Internal medicine