Shahrahmani Fatemeh, Mashhadi Mahdi Parvizi, Khadembashi Alireza, Shaye Zahra Abbasi, Bagheri Elham, Shojaeian Reza
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Pediatric Surgery, Mashhad University of Medical Sciences, Vakil Abad Street, Mashhad, Khorasan Razavi, Iran.
Pediatr Surg Int. 2025 May 30;41(1):151. doi: 10.1007/s00383-025-06049-z.
Enhanced Recovery After Surgery (ERAS) is a multidisciplinary approach designed to minimize physiological stress and improve recovery. This study evaluated the impact of ERAS protocols on pediatric patients undergoing colostomy closure.
A prospective, randomized clinical trial was conducted at a tertiary center from May 2020 to July 2022. Seventy-seven pediatric patients admitted for colostomy closure were randomly assigned to the ERAS group (ERASG, n = 36) or the control group (CG, n = 41). The ERAS protocol included preoperative, intraoperative, and postoperative strategies to enhance outcomes. Primary outcomes included length of hospital stay (LOS), time to oral feeding, narcotic consumption, complications, and one-month readmission rates.
The mean LOS was significantly shorter in the ERASG (3.30 ± 0.95 days) compared to the CG (6.43 ± 3.80 days; p = 0.002). The ERASG showed a significant reduction in the median time to resuming a regular diet (p = 0.001) and average narcotic use (p = 0.015). No significant differences were observed in postoperative complications or readmission rates.
ERAS implementation in pediatric colostomy closure significantly reduced LOS, narcotic use, and time to oral feeding without increasing complications or readmissions, supporting its feasibility and safety in pediatric colorectal surgery.
术后加速康复（ERAS）是一种多学科方法，旨在将生理应激降至最低并改善康复情况。本研究评估了ERAS方案对接受结肠造口关闭术的儿科患者的影响。
于2020年5月至2022年7月在一家三级中心进行了一项前瞻性随机临床试验。77名因结肠造口关闭术入院的儿科患者被随机分配至ERAS组（ERASG，n = 36）或对照组（CG，n = 41）。ERAS方案包括术前、术中和术后策略以改善结局。主要结局包括住院时间（LOS）、开始经口进食的时间、麻醉药物消耗量、并发症及1个月再入院率。
与CG组（6.43±3.80天）相比，ERASG组的平均LOS显著缩短（3.30±0.95天；p = 0.002）。ERASG组恢复正常饮食的中位时间（p = 0.001）和平均麻醉药物使用量（p = 0.015）显著降低。术后并发症或再入院率未观察到显著差异。
在儿科结肠造口关闭术中实施ERAS可显著缩短LOS、减少麻醉药物使用及经口进食时间，且不增加并发症或再入院率，支持其在小儿结直肠手术中的可行性和安全性。
