Short Heather L, Taylor Natalie, Thakore Mitali, Piper Kaitlin, Baxter Katherine, Heiss Kurt F, Raval Mehul V
Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Rollins School of Public Health, Emory University, Atlanta, GA, USA.
J Pediatr Surg. 2018 Mar;53(3):418-430. doi: 10.1016/j.jpedsurg.2017.06.007. Epub 2017 Jun 17.
Enhanced Recovery After Surgery (ERAS) protocols have been shown to improve outcomes in adult abdominal surgical populations. Our purpose was to survey pediatric surgeons' opinions regarding applicability of individual ERAS elements to children's surgery.
A survey of the American Pediatric Surgical Association was conducted electronically. Using a 5-point Likert scale, respondents rated their willingness to implement 21 adult ERAS elements in an adolescent undergoing elective colorectal surgery.
Of an estimated 1052 members, 257 completed the survey (24%). The majority of the respondents (n=175, 68.4%) rated their familiarity with ERAS as "moderately", "very", or "extremely familiar". However only 19.2% (n=49) replied that they were "already implementing" an ERAS protocol in their practice. Most respondents replied that they were "already doing" or "definitely willing" to implement 14 of the 21 (67%) ERAS elements. For the remaining 7 elements, >10% of surgeons answered that they were only "somewhat willing" to, "uncertain" about or "unwilling" to implement these interventions.
Most respondents were willing to implement the majority of adult ERAS concepts in children undergoing abdominal surgery. However, we identified 7 elements that remain contentious. Further investigation regarding the safety and feasibility of these elements is warranted before applying them to children's surgery.
Level V.
手术加速康复（ERAS）方案已被证明可改善成人腹部手术患者的预后。我们的目的是调查小儿外科医生对于ERAS各个要素应用于儿童手术的看法。
对美国小儿外科协会进行了电子问卷调查。采用5分李克特量表，受访者对他们在一名接受择期结直肠手术的青少年患者中实施21项成人ERAS要素的意愿进行评分。
估计有1052名成员，257人完成了调查（24%）。大多数受访者（n = 175，68.4%）将他们对ERAS的熟悉程度评为“中等”“非常”或“极其熟悉”。然而，只有19.2%（n = 49）的人回答他们在实践中“已经在实施”ERAS方案。大多数受访者回答他们“已经在做”或“肯定愿意”实施21项ERAS要素中的14项（67%）。对于其余7项要素，超过10%的外科医生回答他们只是“有点愿意”“不确定”或“不愿意”实施这些干预措施。
大多数受访者愿意在接受腹部手术的儿童中实施大多数成人ERAS概念。然而，我们确定了7项仍存在争议的要素。在将这些要素应用于儿童手术之前，有必要对其安全性和可行性进行进一步调查。
V级。
