Summary
Purpose
To offer an up-to-date appraisal of the current status of enhanced recovery after
surgery (ERAS) protocols in pediatric urology and to provide a guide for the clinical
urologist.
Materials and methods
We performed a comprehensive literature search and scoping review on ERAS protocols
in pediatric urology using Pubmed (from 1946), Cochrane library, and MEDLINE to December
2021 with the terms ‘‘enhanced recovery’’, ‘‘protocolised care’’, ‘‘post-operative
protocol”, ‘‘fast-track surgery’’ and ‘‘pediatric urology”. Studies were excluded
if they did not include perioperative intervention related to urological procedures,
no full-text available and in non-English language.
Results
To date, eight clinical studies (involving 1153 patients) have been published on ERAS
protocols in pediatric urology. The patients involved ranged from neonates to adolescents,
and the urological procedures included bladder augmentation, the Mitrofanoff procedure,
laparoscopic pyeloplasty, laparoscopic nephrectomy, hypospadias repair, etc. Multidisciplinary
components such as surgical and anesthetic considerations have been employed in ERAS
protocols. The length of hospital stay was significantly lower in the ERAS groups
with earlier enteral feeding resumption and return of bowel function in pediatric
urology patients. The implementation of ERAS protocols does not result in higher complication
and readmission rates; instead, some studies have even demonstrated a significant
reduction in complication occurrence.
Conclusion
ERAS is novel to pediatric urology with a limited scale of published data in the literature.
Initial clinical studies revealed that ERAS appears to be efficacious in the field
of pediatric urology. Further prospective studies formulating a standardized multimodal
protocol are encouraged to better understand key components of ERAS and incorporate
ERAS into clinical practice to optimize surgical outcomes for pediatric urology procedures.
Keywords
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Article info
Publication history
Published online: August 02, 2022
Accepted:
July 25,
2022
Received in revised form:
June 4,
2022
Received:
March 3,
2022
Identification
Copyright
© 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
