Enhanced recovery management in pediatric pyeloplasty : outcomes in a single institution and tips for improvement
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..
OBJECTIVE: We report the application of enhanced recovery after surgery (ERAS) regimens to pediatric patients undergoing laparoscopic pyeloplasty (LP), aiming to guide the practice of ERAS in pediatric LP.
METHODS: From October 2018, we prospectively implemented a twenty-point ERAS regimen, including a modified LP procedure, for pediatric UPJO patients in a single institution. Data from 2018 to 2021 were collected and analyzed retrospectively. The variables gathered included: demographics, preoperative details and recovery elements. Outcomes were postoperative length of stay (POS), readmission rate, operation time and blood loss.
RESULTS: A total of 75 pediatric patients (0-14 years) were included. The mean POS was 2.4 ± 1.4 days, shorter than that in recent studies in China (3.3 ± 1.4 days, 6 (3-16) days). None were redo, and six restenosis (8%) were improved after treatment with ureteral balloon dilatation. The mean operation time was 257.9 ± 54.4 min, and blood loss was 11.8 ± 10.0 ml. In the univariable analysis and multivariable analysis, no external drainage, sacral anesthesia, and withdrawal of the catheter on day one were independently associated with a POS of ≤ 2 d (p < 0.05).
CONCLUSION: The implementation of this ERAS protocol for pediatric LP has resulted in a shorter length of stay without a higher readmission rate. Surgery techniques, drainage management and analgesia are the key to further improvement. ERAS for pediatric pyeloplasty should be encouraged.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
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| Enthalten in: |
World journal of urology - 41(2023), 6 vom: 19. Juni, Seite 1667-1673 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
He, Jiannan [VerfasserIn] |
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| Anmerkungen: |
Date Completed 17.08.2023 Date Revised 17.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00345-023-04422-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357220226 |
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| 520 | |a © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a OBJECTIVE: We report the application of enhanced recovery after surgery (ERAS) regimens to pediatric patients undergoing laparoscopic pyeloplasty (LP), aiming to guide the practice of ERAS in pediatric LP | ||
| 520 | |a METHODS: From October 2018, we prospectively implemented a twenty-point ERAS regimen, including a modified LP procedure, for pediatric UPJO patients in a single institution. Data from 2018 to 2021 were collected and analyzed retrospectively. The variables gathered included: demographics, preoperative details and recovery elements. Outcomes were postoperative length of stay (POS), readmission rate, operation time and blood loss | ||
| 520 | |a RESULTS: A total of 75 pediatric patients (0-14 years) were included. The mean POS was 2.4 ± 1.4 days, shorter than that in recent studies in China (3.3 ± 1.4 days, 6 (3-16) days). None were redo, and six restenosis (8%) were improved after treatment with ureteral balloon dilatation. The mean operation time was 257.9 ± 54.4 min, and blood loss was 11.8 ± 10.0 ml. In the univariable analysis and multivariable analysis, no external drainage, sacral anesthesia, and withdrawal of the catheter on day one were independently associated with a POS of ≤ 2 d (p < 0.05) | ||
| 520 | |a CONCLUSION: The implementation of this ERAS protocol for pediatric LP has resulted in a shorter length of stay without a higher readmission rate. Surgery techniques, drainage management and analgesia are the key to further improvement. ERAS for pediatric pyeloplasty should be encouraged | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a ERAS | |
| 650 | 4 | |a Pediatric | |
| 650 | 4 | |a Pyeloplasty | |
| 650 | 4 | |a Surgical techniques | |
| 700 | 1 | |a Lai, Huajian |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Tianyou |e verfasserin |4 aut | |
| 700 | 1 | |a Ye, Lei |e verfasserin |4 aut | |
| 700 | 1 | |a Yao, Bing |e verfasserin |4 aut | |
| 700 | 1 | |a Qu, Hu |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Bo |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Qiang |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Yifei |e verfasserin |4 aut | |
| 700 | 1 | |a Qiu, Jianguang |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Dejuan |e verfasserin |4 aut | |
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