Enhanced recovery protocol for congenital duodenal obstruction - initial experiences with development and implementation.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-12-27 DOI:10.1007/s00383-024-05951-2

Henrik Røkkum, Martin Alavi Treider, Wenche Bakken Børke, Janicke Bergersen, Kristoffer Lassen, Ragnhild Støen, Thorstein Sæter, Kristin Bjørnland

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引用次数: 0

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

查看原文本刊更多论文

先天性十二指肠梗阻的增强恢复方案-发展和实施的初步经验。

背景：在新生儿肠道手术中应用ERAS （Enhanced Recovery After Surgery®）方案的经验非常有限。我们提出了一种专门为先天性十二指肠梗阻（CDO）治疗的新生儿设计的增强恢复方案（ERP）的发展和实施，以及实施后的早期结果。方法：开发并实施了面向CDO的ERP系统。描述了ERP开发和实施的经验。比较实施前（2015年1月- 2020年12月）和实施后（2022年2月- 2024年9月）患者的早期临床结果。获得伦理批准。结果：建立了多学科ERP团队。面向CDO的ERP是在利益相关者的参与下开发的。实施具有挑战性，但通过密切随访和与相关医学学科的频繁会议，实施后治疗的21例患者的ERP总体依从性达到80%。与实施ERP前（2015年1月- 2020年12月）治疗的40例患者相比，微创手术的使用增加，术后首次肠内和母乳喂养的时间减少，未增加术后并发症的发生率。结论：本研究提出了一个专门为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的描述。初步结果表明，该方法是可行且安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor