Purpose This study aimed to evaluate the safety and efficacy of enhanced recovery after surgery (ERAS) protocols in pediatric patients undergoing laparoscopic-assisted resection for Meckel’s diverticulum (MD) or intestinal duplication (ID). Methods A retrospective cohort analysis was conducted on 96 pediatric patients who underwent laparoscopic-assisted resection for MD or ID at our institution between January 2017 and July 2025, covering the periods pre- and post-ERAS implementation. Patients were stratified into two groups: the ERAS group (n = 49), managed per ERAS protocols, and the traditional (TRAD) group (n = 47), receiving conventional perioperative care. Demographic characteristics, perioperative outcomes, and laboratory parameters were systematically compared between groups. Results All procedures were performed by a consistent surgical team, with no significant differences in baseline characteristics between groups (all P > 0.05). The ERAS group exhibited superior outcomes: (1) Recovery: shorter median postoperative length of stay (LOS) (7.00 vs. 9.00 days, P < 0.001) and consistently lower FLACC pain scores at 2–48 h postoperatively (P < 0.001); (2) Laboratory markers: comparable preoperative values (all P > 0.05), but higher glucose levels at anesthesia induction (P < 0.001) and favorable postoperative laboratory profiles (lower C-reactive protein [CRP], neutrophil [NEUT] count, and glucose; higher prealbumin; all P < 0.05); (3) Clinical benefits: reduced urinary catheter utilization and duration (both P < 0.05), accelerated achievement of recovery milestones (mobility, flatus, oral intake, total enteral nutrition initiation, and intravenous infusion cessation; all P < 0.001), and lower healthcare costs (P < 0.001) without compromising safety (complication and readmission rates, both P > 0.05). ERAS-related advantages were more pronounced, with a non-significant trend toward higher parental satisfaction (P = 0.444). Conclusions ERAS protocols safely optimize recovery in pediatric patients undergoing laparoscopic-assisted resection for small intestinal malformations (MD/ID) without adversely affecting clinical outcomes.

Advancing enhanced recovery after surgery protocols for pediatric laparoscopic-assisted small intestinal malformation repair

期刊论文
出版模式：

开放获取
发表日期：

2026年1月20日

查看全文

Kai Zhu,
Hengfei Gao,
Yaqi Chen,
Ying Zhou,
Mingyun Hong,
Yilin Su

摘要

Purpose

This study aimed to evaluate the safety and efficacy of enhanced recovery after surgery (ERAS) protocols in pediatric patients undergoing laparoscopic-assisted resection for Meckel’s diverticulum (MD) or intestinal duplication (ID).

Methods

A retrospective cohort analysis was conducted on 96 pediatric patients who underwent laparoscopic-assisted resection for MD or ID at our institution between January 2017 and July 2025, covering the periods pre- and post-ERAS implementation. Patients were stratified into two groups: the ERAS group (n = 49), managed per ERAS protocols, and the traditional (TRAD) group (n = 47), receiving conventional perioperative care. Demographic characteristics, perioperative outcomes, and laboratory parameters were systematically compared between groups.

Results

All procedures were performed by a consistent surgical team, with no significant differences in baseline characteristics between groups (all P > 0.05). The ERAS group exhibited superior outcomes: (1) Recovery: shorter median postoperative length of stay (LOS) (7.00 vs. 9.00 days, P < 0.001) and consistently lower FLACC pain scores at 2–48 h postoperatively (P < 0.001); (2) Laboratory markers: comparable preoperative values (all P > 0.05), but higher glucose levels at anesthesia induction (P < 0.001) and favorable postoperative laboratory profiles (lower C-reactive protein [CRP], neutrophil [NEUT] count, and glucose; higher prealbumin; all P < 0.05); (3) Clinical benefits: reduced urinary catheter utilization and duration (both P < 0.05), accelerated achievement of recovery milestones (mobility, flatus, oral intake, total enteral nutrition initiation, and intravenous infusion cessation; all P < 0.001), and lower healthcare costs (P < 0.001) without compromising safety (complication and readmission rates, both P > 0.05). ERAS-related advantages were more pronounced, with a non-significant trend toward higher parental satisfaction (P = 0.444).

Conclusions

ERAS protocols safely optimize recovery in pediatric patients undergoing laparoscopic-assisted resection for small intestinal malformations (MD/ID) without adversely affecting clinical outcomes.