Adopting Enhanced Recovery Protocols Aids Pediatric GI Surgery Outcomes

TUESDAY, June 2, 2026 (HealthDay News) -- Implementing elements of enhanced recovery protocols (ERPs) improves outcomes for children undergoing gastrointestinal (GI) surgery, according to a study published online May 13 in JAMA Surgery.Mehul V. Raval, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues assessed the implementation and clinical effectiveness of a consensus-based ERP for pediatric patients undergoing elective GI surgery. The analysis included 597 pediatric patients (aged 10 to 18 years) undergoing elective GI surgery at 18 U.S. sites from September 2019 to June 2024. Sites were randomly assigned to three groups, each spending at least nine months in a control phase (usual care), followed by an implementation phase at six-month intervals that included a 21-element ERP program supported by a structured implementation toolkit, based on five active implementation frameworks, and a sustainment phase (12 to 24 months).The researchers found no significant differences by study phase in length of stay (LOS) or secondary outcomes, except a shorter time to regular diet and decreased opioid use during hospitalization (average opioid use per day dropped by 56 percent for the third phase versus preimplementation). Patients who received at least 13 ERP elements had shorter median LOS (−1.14 days) and fewer complications (adjusted odds ratio, 0.48). Patient-level adherence increased by study phase (number of ERPs: 11, 14, and 14). There was a moderate correlation with fidelity between ERP integration into order sets and site culture. "ERPs have been shown to improve outcomes for adults undergoing surgery for nearly 20 years, yet adoption for children has lagged with most studies having modest sample sizes and coming from single hospital experiences," Raval said in a statement. "We are excited to show that ERPs lead to better outcomes for children after surgery."One author disclosed ties to the pharmaceutical industry.Abstract/Full Text.Sign up for our weekly HealthDay newsletter

Adopting Enhanced Recovery Protocols Aids Pediatric GI Surgery Outcomes

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