ISSN: 2578-4838
Authors: Kumba C*, Blanc T, De Cock A, Willems A, Harte C, Querciagrossa S, Orliaguet G and Mélot C
Introduction: In adult surgical patients rapid recovery pathways after surgery have shown improvement in postoperative complications and length of hospital stay. Enhanced recovery after surgery is a concept which includes patient management protocols beginning from the preoperative period, continues in the intraoperative period and the postoperative period. This concept aims to improve postoperative outcome. In pediatric patients rapid recovery pathways are beginning to develop. This study was undertaken to analyse whether enhanced recovery after surgery improved postoperative outcome in terms of postoperative complications and length of hospital stay in children. Methods: After registration of this study in Prospero under the number [CRD42018103518], a systematic review and meta-analysis of randomised and non randomised trials was realised in April 2019 using electronic databases in children less than 18 years old where enhanced rapid recovery pathways after surgery were applied and compared to standard care. Statistic analysis was realised with RevMan 5.3 software. Results: 6 studies with 1620 children <18 years old were included in hypospadias, idiopathic scoliosis and appendicitis surgery. 1) In 1482 children, the number of patients with postoperative complications (infections, reoperations, bleeding) was lower in the enhanced recovery group, odds ratio 0.49 [0.26-0.91], p=0.02. 2) In 1168 children, length of hospital stay was lower in the enhanced recovery group, p= 0.0002. Conclusion: This study demonstrated that when enhanced recovery protocols were applied in hypospadias, idiopathic scoliosis and appendicitis surgery, the number of patients with postoperative complications and length of hospital stay were reduced.
Keywords: Enhanced Recovery Pathways; Children; Outcome
