Wang Mi-Yan, Chen Xiao-Hong, He Xiao-Chun, Yang Zhou-Jian, Yang Yu-Wei, Yang Jian, He Hui-Lin
Department of Pediatric Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China.
Department of Laboratory Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China.
World J Gastrointest Surg. 2025 Jun 27;17(6):105739. doi: 10.4240/wjgs.v17.i6.105739.
Enhanced recovery after surgery (ERAS) represents an innovative, protocol-driven perioperative care program designed to optimize patient outcomes. However, its application and efficacy in infants and children with Hirschsprung disease (HD) remain underexplored.
To delve into the impact of ERAS on perioperative recovery and the overall medical experience in HD infants and children.
Thirty-eight infants and children with HD who received the Soave surgical procedure were enrolled in this case-control study. According to age- and sex-stratified single-blind randomized tables, 20 cases received ERAS treatment (ERAS group) and 18 cases received conventional treatment (control group). The two treatments were then compared in terms of perioperative recovery and medical experience.
Significant differences were observed in pain scores at awakening (4.2 ± 1.3 5.2 ± 1.2, = 2.516, = 0.017) and pain duration (85.69 ± 7.46 hours 67.00 ± 8.56 hours, = 7.139, < 0.001) between the ERAS and control group. The recovery of bowel movement was earlier in the ERAS group than in the control group (borborygmus time: 33.63 ± 9.83 hours 44.69 ± 16.85 hours, = 2.501, = 0.017; feeding time: 36.63 ± 9.55 hours 49.36 ± 16.99 hours, = 2.884, = 0.007; anal catheter indwelling time: 75.83 ± 13.80 hours 93.36 ± 20.65 hours, = 3.104, = 0.004), and fever duration (40.73 ± 14.42 hours 52.63 ± 18.69 hours, = 2.211, = 0.034). In the ERAS group, hospital stay was shorter (7.5 ± 0.9 days 8.3 ± 1.2 days) and the cost was lower (14203 ± 2381 yuan 16847 ± 3558 yuan). During the 1-month follow-up period, of the multiple postoperative complications observed, the occurrence of perianal dermatitis ( = 0.016) and defecation dysfunction ( = 0.027) were lower in the ERAS group than in the control group.
The ERAS protocol has the potential to profoundly enhance postoperative recovery and significantly elevate the overall comfort and quality of the medical experience, making it an indispensable approach that warrants widespread adoption. Continuous refinement through evidence-based practices is anticipated to further optimize its efficacy.
术后加速康复（ERAS）是一种创新的、基于方案驱动的围手术期护理计划，旨在优化患者预后。然而，其在患有先天性巨结肠（HD）的婴幼儿中的应用和疗效仍未得到充分探索。
探讨ERAS对HD婴幼儿围手术期恢复及整体医疗体验的影响。
本病例对照研究纳入了38例接受Soave手术的HD婴幼儿。根据年龄和性别分层的单盲随机表，20例接受ERAS治疗（ERAS组），18例接受传统治疗（对照组）。然后比较两种治疗方法在围手术期恢复和医疗体验方面的差异。
ERAS组与对照组在苏醒时疼痛评分（4.2±1.3对5.2±1.2，t = 2.516，P = 0.017）和疼痛持续时间（85.69±7.46小时对67.00±8.56小时，t = 7.139，P < 0.001）方面存在显著差异。ERAS组肠道蠕动恢复较对照组更早（肠鸣音时间：33.63±9.83小时对44.69±16.85小时，t = 2.501，P = 0.017；进食时间：36.63±9.55小时对49.36±16.99小时，t = 2.884，P = 0.007；肛门导管留置时间：75.83±13.80小时对93.36±20.65小时，t = 3.104，P = 0.004），发热持续时间（40.73±14.42小时对52.63±18.69小时，t = 2.211，P = 0.034）。ERAS组住院时间更短（7.5±0.9天对8.3±1.2天），费用更低（14203±2381元对16847±3558元）。在1个月的随访期内，观察到的多种术后并发症中，ERAS组肛周皮炎（P = 0.016）和排便功能障碍（P = 0.027）的发生率低于对照组。
ERAS方案有可能显著促进术后恢复，并显著提高整体舒适度和医疗体验质量，使其成为一种不可或缺的方法，值得广泛采用。预计通过循证实践不断完善将进一步优化其疗效。
