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The effect of an enhanced recovery protocol in pediatric patients who undergo colostomy closure and Malone procedures.
Reppucci, Marina L; Wehrli, Lea A; Schletker, Julie; Nolan, Margo M; Rieck, Jared; Fares, Souha; Ketzer, Jill; Rove, Kyle; Pena, Alberto; de la Torre, Luis; Bischoff, Andrea.
Afiliação
  • Reppucci ML; International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, Anschutz Medical Campus, Children's Hospital Colorado, 13213 E 16th Ave, Box 323, Aurora, CO, 80045, USA.
  • Wehrli LA; International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, Anschutz Medical Campus, Children's Hospital Colorado, 13213 E 16th Ave, Box 323, Aurora, CO, 80045, USA.
  • Schletker J; International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, Anschutz Medical Campus, Children's Hospital Colorado, 13213 E 16th Ave, Box 323, Aurora, CO, 80045, USA.
  • Nolan MM; International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, Anschutz Medical Campus, Children's Hospital Colorado, 13213 E 16th Ave, Box 323, Aurora, CO, 80045, USA.
  • Rieck J; Research in Outcomes in Children's Surgery, Children's Hospital Colorado, Aurora, CO, USA.
  • Fares S; Research in Outcomes in Children's Surgery, Children's Hospital Colorado, Aurora, CO, USA.
  • Ketzer J; International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, Anschutz Medical Campus, Children's Hospital Colorado, 13213 E 16th Ave, Box 323, Aurora, CO, 80045, USA.
  • Rove K; Department of Pediatric Urology, Children's Hospital Colorado, Aurora, CO, USA.
  • Pena A; International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, Anschutz Medical Campus, Children's Hospital Colorado, 13213 E 16th Ave, Box 323, Aurora, CO, 80045, USA.
  • de la Torre L; International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, Anschutz Medical Campus, Children's Hospital Colorado, 13213 E 16th Ave, Box 323, Aurora, CO, 80045, USA.
  • Bischoff A; International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, Anschutz Medical Campus, Children's Hospital Colorado, 13213 E 16th Ave, Box 323, Aurora, CO, 80045, USA. andrea.bischoff@childrenscolorado.org.
Pediatr Surg Int ; 38(12): 1701-1707, 2022 Dec.
Article em En | MEDLINE | ID: mdl-36098796
PURPOSE: Pediatric colorectal studies have shown enhanced recovery after surgery (ERAS) protocols can safely improve outcomes. This study sought to determine the impact of an ERAS pathway on the outcomes of children with colorectal conditions who underwent colostomy closure or Malone procedure. METHODS: A single-institution, retrospective cohort study of children who underwent colostomy closure or Malone procedure between 2016 and 2020 was performed. Differences in outcomes between pre-ERAS and ERAS cohorts were tested. A sub-analysis based on procedure type was performed. RESULTS: There were 96 patients included: 22 prior to ERAS implementation and 74 after. Patients who underwent ERAS had shorter mean time (hours) to oral intake, mean days until regular diet, post-operative opioid volume, and median length of stay (p < 0.05). There was no difference in complication rates in the ERAS and pre-ERAS cohort (12.2 vs 9.1%, p = 0.99). Patients who underwent colostomy closure after ERAS had lower post-operative opioid use, but no differences were seen in those who underwent Malone. CONCLUSION: Implementation of an ERAS protocol resulted in quicker time to oral intake, normal diet, and decreased opioid use without increasing complication rates. Differences seen based on procedure type may reflect that the effect of an ERAS protocol is procedure specific.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Analgésicos Opioides Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Analgésicos Opioides Idioma: En Ano de publicação: 2022 Tipo de documento: Article