Implementation of a Standardized Pediatric ERAS-Based Protocol in Children Undergoing Elective Intestinal Resection With Primary Anastomosis: A Multicenter Prospective Study

What this Trial Is About

Enhanced Recovery After Surgery (ERAS) is a care approach used during the period surrounding surgery to reduce stress, lower complications, and speed recovery. While ERAS is common in adult surgeries, its use in children, especially for intestinal surgery, is limited and lacks standardized guidelines. This multicenter prospective study in Poland aims to assess the safety, feasibility, and outcomes of a pediatric ERAS protocol in children undergoing elective intestinal resection with primary anastomosis, excluding those with Hirschsprung disease due to their unique conditions. The study involves 60 children treated in nine pediatric surgery centers, all managed under the same standardized ERAS protocol. This protocol includes preoperative education, nutritional assessment, reduced fasting, preoperative carbohydrate loading, multimodal pain control including regional anesthesia, optimized fluid management during surgery, minimal use of devices like tubes and drains, early removal of catheters, early mobilization, and early oral feeding. Patients managed with this protocol will be compared to a historical group treated before ERAS implementation. Participants will be closely monitored for adherence to the protocol and evaluated using age-appropriate pain scales. Researchers will track various outcomes such as length of hospital stay, timing of oral feeding, postoperative complications, pain control, and readmissions within 30 days. The study aims to provide strong evidence to support pediatric ERAS use and help create national care guidelines for children undergoing intestinal surgery in Poland.

Implementation of a Pediatric ERAS-based Protocol in Intestinal Resection With Primary Anastomosis