META-ANALYSIS OF ENHANCED RECOVERY AFTER SURGERY PROTOCOLS AND THEIR IMPACT ON POSTOPERATIVE RECOVERY IN PEDIATRIC HIRSCHSPRUNG’S DISEASE: IMPLICATIONS FOR PEDIATRIC SPORTS HEALTH

Authors

  • Min Ou Department of Critical Care Medicine，West China Hospital，Sichuan University/ West China School of Nursing，Sichuan University，Cheng Du, 610000, China.
  • Yulan Luo Department of Critical Care Medicine，West China Hospital，Sichuan University/ West China School of Nursing，Sichuan University，Cheng Du, 610000, China.
  • Xiaopeng Sun Department of Hemodialysis, Department of Nephrology, Chengdu Hospital of Integrated Traditional Chinese and Western Medicine, Chengdu, 610000, China
  • Min Wang Department of Neonatology, West China Second Hospital, Sichuan University, Chengdu, 610000, China.
  • Mei Feng 1 Department of Critical Care Medicine，West China Hospital，Sichuan University/ West China School of Nursing，Sichuan University，Cheng Du, 610000, China.

Keywords:

congenital megacolon; The concept of rapid rehabilitation surgery; Postoperative rehabilitation

Abstract

Objective: This meta-analysis aimed to evaluate the impact of the enhanced recovery after surgery (ERAS) protocol on the postoperative rehabilitation of athletic children diagnosed with Hirschsprung's disease. Methods: Comprehensive searches of international databases such as PubMed, MEDLINE, and EMBASE, as well as Chinese databases including CNKI and Wanfang, were conducted to identify studies published from January 2014 to the present. These studies investigated the outcomes of the ERAS protocol in pediatric patients undergoing surgery for Hirschsprung's disease. The primary outcomes assessed were length of hospital stay, time to first bowel movement, time to start enteral feeding, and incidence of postoperative complications. Data were extracted and meta-analysis was performed using RevMan 5 software. Results: The analysis included eight studies encompassing 677 athletic participants, with 376 in the ERAS group and 301 in the conventional care group. The ERAS protocol significantly reduced the length of hospital stay (Weighted Mean Difference [WMD] = -4.71 days, 95% CI: -4.97 to -4.44), time to first bowel movement (WMD = -2.16 hours, 95% CI: -2.49 to -1.82), and time to start enteral feeding (WMD = -11.95 hours, 95% CI: -13.99 to -9.92). Additionally, there was a substantial reduction in the incidence of postoperative complications (Odds Ratio [OR] = 0.22, 95% CI: 0.14 to 0.36) compared to conventional care. Conclusion: The ERAS protocol significantly enhances postoperative recovery in children with Hirschsprung's disease, as evidenced by shortened hospital stays, quicker return to bowel function, earlier initiation of feeding, and fewer complications. These findings support the widespread implementation of ERAS protocols in pediatric surgical practices to improve outcomes and enhance recovery in children undergoing surgery for Hirschsprung's disease.

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Published

2024-02-01

Issue

Vol. 24 No. 96 (2024): Vol. 24, No. 96 junio/June 2024

Section

Manuscript