Pei Jun, Wang Shili, Pan Xingyu, Wu Moudong, Zhan Xiong, Fang Kaiyun, Wang Dan, Wang Wei, Zhu Guohua, Tang Hongyu, An Nini, Peng Jinpu
Department of Pediatric Surgrey, Guizhou Provincial People's Hospital, Guiyang, 550002, China.
Department of Anesthesiology, Guizhou Provincial People's Hospital, Guiyang, 550002, China.
J Pediatr Urol. 2025 Feb;21(1):181-190. doi: 10.1016/j.jpurol.2024.09.019. Epub 2024 Sep 26.
To assess the effects of the enhanced recovery after surgery (ERAS) perioperative protocol on the outcomes of robot-assisted laparoscopic pyeloplasty (RALP) in pediatric patients.
A total of 57 children who underwent RALP at our center between November 2021 and December 2023 were included in the study. They were randomly assigned to either the ERAS (intervention) group or the non-ERAS (control) group. The analysis focused on comparing the length of hospital stay, recovery of gastrointestinal function, incidence of complications within 90 days post-surgery, postoperative extubation time (urinary tube and double-J tube), postoperative auxiliary examinations, and readmission rates within 30 days. Additionally, the patients were divided into two age groups: <4 years old and ≥4 years old, to assess pain severity.
There were no significant differences in preoperative general information, preoperative auxiliary examination findings, or intraoperative conditions between the ERAS and non-ERAS groups. The ERAS group had a significantly shorter postoperative hospital stay compared to the non-ERAS group. Furthermore, the time to the first postoperative bowel movement was shorter, and the incidence of postoperative complications was significantly lower in the ERAS group. Among children <4 years old, there was no significant difference in pain severity between the two groups. However, in children ≥4 years old, the ERAS group experienced significantly lower pain levels at 6 and 24 h post-surgery compared to the non-ERAS group.
The findings of this prospective randomized controlled trial should determine if ERAS is superior to traditional perioperative management in children undergoing RALP, particularly regarding postoperative hospital stay, intestinal function recovery, pain response, and complication rates. We anticipate that our data will offer valuable clinical insights and guidance for the implementation of ERAS in pediatric robotic surgery for urinary diseases.
The ERAS protocol can reduce the length of hospital stay, aid in the recovery of gastrointestinal function, and lower postoperative complication rates. It also has the potential to lessen postoperative pain to varying degrees in certain pediatric patients. ERAS is a safe and effective protocol for pediatric patients undergoing RALP.
评估手术加速康复（ERAS）围手术期方案对小儿机器人辅助腹腔镜肾盂成形术（RALP）手术结局的影响。
本研究纳入了2021年11月至2023年12月在本中心接受RALP手术的57例儿童。他们被随机分为ERAS（干预）组或非ERAS（对照）组。分析重点比较住院时间、胃肠功能恢复情况、术后90天内并发症发生率、术后拔管时间（尿管和双J管）、术后辅助检查以及30天内再入院率。此外，将患者分为两个年龄组：<4岁和≥4岁，以评估疼痛严重程度。
ERAS组和非ERAS组在术前一般信息、术前辅助检查结果或术中情况方面无显著差异。与非ERAS组相比，ERAS组术后住院时间明显缩短。此外，ERAS组术后首次排便时间更短，术后并发症发生率显著更低。在<4岁的儿童中，两组疼痛严重程度无显著差异。然而，在≥4岁的儿童中，与非ERAS组相比，ERAS组在术后6小时和24小时疼痛程度明显更低。
这项前瞻性随机对照试验的结果应能确定ERAS在接受RALP手术的儿童中是否优于传统围手术期管理，特别是在术后住院时间、肠道功能恢复、疼痛反应和并发症发生率方面。我们预计我们的数据将为在小儿泌尿系统疾病机器人手术中实施ERAS提供有价值的临床见解和指导。
ERAS方案可缩短住院时间，有助于胃肠功能恢复，并降低术后并发症发生率。它还有可能在一定程度上减轻某些小儿患者的术后疼痛。ERAS是小儿患者接受RALP手术的一种安全有效的方案。
