Cassaro Fabiola, Impellizzeri Pietro, Maisano Giulia, Romeo Carmelo, Arena Salvatore
Unit of Pediatric Surgery, Department of Human Pathology of Adult and Childhood "Gaetano Barresi", University of Messina, 98125, Messina, Italy.
Department of Biomedical and Dental Sciences and Morpho-functional Imaging, University of Messina, 98125, Messina, Italia.
Pediatr Surg Int. 2025 Apr 9;41(1):110. doi: 10.1007/s00383-025-06017-7.
Enhanced Recovery After Surgery (ERAS) is a protocol that includes rules aimed to minimize surgical stress and to reduce the post-operative period. Initially applied in intestinal surgery of adults, a recent meta-analysis suggested that ERAS is valid also in pediatric gastrointestinal surgery. This study systematically reviewed and performed a meta-analysis to evaluate ERAS benefits in pediatric urological reconstructive surgery. A PubMed search identified studies comparing ERAS and traditional protocols in pediatric urological reconstructive surgery. Data on major and minor complications, hospital readmission, and length of hospital stay were collected and analyzed. Analyses were performed using OR and Cl 95%. A p-value < 0.05 was considered significant. A total of 10 papers met the inclusion criteria, with 1410 included patients (492 ERAS group, 918 No-ERAS). There were significant differences in major complications (p < 0.001) and length of stay (p < 0.001) and the incidence of minor complications (p = 0.002) favoring patients undergoing ERAS protocol; differently, there was no difference in hospital readmission (p = 0.763). ERAS protocol is safe and feasible for children undergoing reconstructive urological surgery, reducing the risks of complications and the length of hospital stay, without increasing readmission risk. ERAS should also be a standardized procedure in pediatric reconstructive urological surgery.
术后加速康复（ERAS）是一种方案，包括旨在将手术应激降至最低并缩短术后恢复时间的规则。最初应用于成人肠道手术，最近的一项荟萃分析表明，ERAS在小儿胃肠手术中也有效。本研究系统回顾并进行了一项荟萃分析，以评估ERAS在小儿泌尿外科重建手术中的益处。通过PubMed检索确定了比较小儿泌尿外科重建手术中ERAS和传统方案的研究。收集并分析了有关主要和次要并发症、再次入院情况及住院时间的数据。使用OR和95%CI进行分析。p值<0.05被认为具有统计学意义。共有10篇论文符合纳入标准，纳入患者1410例（ERAS组492例，非ERAS组918例）。在主要并发症（p<0.001）、住院时间（p<0.001）和次要并发症发生率（p=0.002）方面存在显著差异，支持接受ERAS方案的患者；不同的是，再次入院情况无差异（p=0.763）。ERAS方案对于接受泌尿外科重建手术的儿童是安全可行的，可降低并发症风险和缩短住院时间，且不会增加再次入院风险。ERAS也应成为小儿泌尿外科重建手术的标准化程序。
