Enhanced Recovery After Surgery in Pediatric Urology Patients Undergoing Complex Lower Urinary Tract Reconstruction.
Enhanced recovery after surgery protocol linked to 74% drop in postoperative opioid use after pediatric bladder reconstruction.
Enhanced Recovery After Surgery in Pediatric Urology Patients Undergoing Complex Lower Urinary Tract Reconstruction.
IMPORTANCE: Enhanced recovery after surgery (enhanced recovery after surgery) is a multidisciplinary framework to standardize perioperative care.
To attempt to achieve 70% or more enhanced recovery after surgery adherence while reducing length of stay and opioid use without an increase in complications or other balancing measures.
DESIGN, SETTING, AND PARTICIPANTS: This study prospectively enrolled patients who were propensity matched to recent historical controls prior to enhanced recovery after surgery implementation and outcomes were compared.
postoperative opioid use dropped sharply with enhanced recovery after surgery versus prior standard care
A total of 153 enhanced recovery after surgery patients and 153 historical controls were matched with a median (IQR) age of 10.2 (7.6-13.7) and 10.4 (8.0-14.6) years, respectively (P = .47).
Median protocol adherence increased from 8 to 16 measures between historical and enhanced recovery after surgery cohorts (P < .001).
Median length of stay decreased from 8.0 to 5.3 days (P < .001).
Complication rates decreased from 72.5% to 60.1% (P = .01) with no differences in 90-day emergency department visits, readmissions, or reoperations.
In this study, enhanced recovery after surgery was highly effective at standardizing perioperative care in pediatric urology patients undergoing complex lower urinary tract reconstruction.
enhanced recovery after surgery was associated with better outcomes of reduced length of stay, lower postoperative opioid use, and lower complication rates.