Røkkum Henrik, Treider Martin Alavi, Børke Wenche Bakken, Bergersen Janicke, Lassen Kristoffer, Støen Ragnhild, Sæter Thorstein, Bjørnland Kristin
Department of Pediatric Surgery, Oslo University Hospital, Nydalen, P. O. Box 4950, N-0424, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Pediatr Surg Int. 2024 Dec 27;41(1):49. doi: 10.1007/s00383-024-05951-2.
The experience with Enhanced Recovery After Surgery (ERAS) protocols in neonatal intestinal surgery is very limited. We present the development and implementation of an Enhanced Recovery Protocol (ERP) designed specifically for neonates treated for congenital duodenal obstruction (CDO), and early outcome after implementation.
An ERP for CDO was developed and implemented. Experiences with ERP development and implementation are described. Early clinical outcome in patients treated before (January 2015-Descember 2020) and after (February 2022-September 2024) implementation were compared. Ethical approval was obtained.
A multidisciplinary ERP team was established. The ERP for CDO was developed with stakeholder involvement. Implementation was challenging, but with close follow-up and frequent meetings with the involved medical disciplines, an overall ERP compliance of 80% was achieved for the 21 patients treated after implementation. Compared to 40 patients treated before ERP implementation (January 2015-Descember 2020), the use of minimally invasive surgery increased and time to first postoperative enteral and breast feed were reduced, without increasing the rate of postoperative complications.
This study presents an ERP specifically designed for CDO with a unique description of our experiences with the development and implementation process. Early results suggest that this ERP for CDO is feasible and safe.
新生儿肠道手术中加速康复外科（ERAS）方案的经验非常有限。我们介绍了专门为接受先天性十二指肠梗阻（CDO）治疗的新生儿设计的加速康复方案（ERP）的制定与实施情况，以及实施后的早期结果。
制定并实施了针对CDO的ERP。描述了ERP制定与实施的经验。比较了在实施ERP之前（2015年1月至2020年12月）和之后（2022年2月至2024年9月）接受治疗的患者的早期临床结果。获得了伦理批准。
成立了一个多学科ERP团队。在利益相关者的参与下制定了针对CDO的ERP。实施具有挑战性，但通过密切随访以及与相关医学学科的频繁会议，实施后接受治疗的21例患者的ERP总体依从率达到了80%。与ERP实施前（2015年1月至2020年12月）接受治疗的40例患者相比，微创手术的使用增加，术后首次肠内喂养和母乳喂养的时间缩短，且未增加术后并发症发生率。
本研究介绍了专门为CDO设计的ERP，并对我们在开发和实施过程中的经验进行了独特描述。早期结果表明，这种针对CDO的ERP是可行且安全的。
