ArticleAnnals of surgical oncology2025
Implementation of an Enhanced Recovery After Surgery Pathway for Pediatric Surgical Oncology using Quality Improvement Methodology.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Robotic-assisted resection of pediatric intracavitary lesions: expanding the boundaries of minimally invasive surgery.Pediatric surgery international · 2026Article
- Impact of pediatric obesity on abdominal surgery outcome: a narrative review.Frontiers in pediatrics · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnhanced recovery after surgery (ERAS) pathways have demonstrated significant benefits, but often face challenges in implementation due to the scope of process measures and multidisciplinary buy-in required. This study aimed to standardize surgical care for children undergoing solid tumor resection by implementing an ERAS for Tumor (ERAST) pathway. PATIENTS AND
methodsOur ERAST pathway consisted of 20 process measures. Plan-Do-Study-Act (PDSA) cycles were utilized, including implementing standardized pre- and postoperative orders, data-enabled electronic progress note templates, and multidisciplinary preoperative team huddles. Our primary outcome was 80% adherence to protocol process measures. Secondary outcomes included hospital length-of-stay (LOS) and opioid usage. Balancing measures included readmission and/or emergency room visits within 30 days post-procedure.
resultsOver 15 months, 57 patients (63 surgeries) were included. Median adherence to process measures was 89.5%. Intraoperative fluid administration decreased from 12.19 to 5.97 ml/kg/h (p < 0.001). Intraoperative opioid use in abdominal cases fell from 0.37 to 0.24 OME/kg (p = 0.0008); postoperative opioid use dropped from 0.16 to 0.04 OME/kg/day (p < 0.001). Thoracic cases saw post-operative opioid use decrease from 0.30 to 0.13 OME/kg/day (p = 0.0017). Median LOS decreased for laparotomy (4.48-2.87 days), thoracotomy (3.37-2.26 days), and thoracoscopy (1.60-1.15 days), all p < 0.001. There was no difference in readmission and/or emergency room visits pre/post ERAST for all cases.
conclusionsThe ERAST pathway achieved high protocol adherence and led to significant reductions in opioid use and LOS, without worsening balancing measures. This demonstrates the effectiveness of multidisciplinary, protocol-driven recovery pathways in pediatric surgical oncology.
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