Pediatr Surg Int. 2026 May 4;42(1):213. doi: 10.1007/s00383-026-06455-x.
ABSTRACT
PURPOSE: Implementation of Enhanced Recovery After Surgery (ERAS) protocols in paediatric surgery remains limited, despite proven benefits in adults. The barriers to implementation and protocol modifications requires comprehensive detailing in paediatrics. We aimed to determine the practicality and safety of ERAS in paediatric laparoscopies at a tertiary-care center, addressing the context-specific barriers.
METHODS: This was a prospective, single-arm, preliminary study. One hundred thirty-six children, aged 2-14 years, undergoing laparoscopy were enrolled. ERAS elements were implemented perioperatively. The outcomes analysed included protocol compliance, length of hospital stay (LOS), 30-day complications, readmission and mortality rates. The challenges to implementation were noted.
RESULTS: Overall protocol compliance was 82.5 ± 12.4%. There was a significant correlation between adherence to components and LOS (r=-0.642 ; p < 0.01). Time to start liquids/solids and drain removal showed a significant correlation with LOS. No complications and 30-day readmissions were directly attributable to the fast-track concepts. There was no mortality. Key challenges included infrastructure, parental anxiety regarding early discharge and persistently motivating stakeholders to adhere the protocol.
CONCLUSION: Implementing paediatric ERAS protocol is safe and feasible within a tertiary health-setting. A high degree of multidisciplinary commitment can successfully overcome the unique logistic and cultural barriers with an accelerated convalescence.
PMID:42081132 | DOI:10.1007/s00383-026-06455-x
