Fast-Track Pediatric Surgery
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Fast-track surgery was developed by the Danish surgeon Henrik Kehlet in the 1990s. It was initially termed enhanced recovery after surgery (ERAS) and represents a comprehensive perioperative therapeutic concept with the aim to reduce discomfort, the physiological postoperative stress response, postoperative pain, and complications by means of combining organizational and therapeutic measures.
Numerous studies confirmed the safety and effectiveness of fast-track concepts and a substantial reduction of the hospital stay compared with conventional strategies in children and adolescents. These studies showed that the use of fast-track achieves an improvement in patients comfort and the quality of care. The acceptance of fast-track of patients and parents is excellent.
This chapter contains a description of the conceptual background, the development, and the current status of fast-track pediatric surgery.
KeywordsFast-track surgery Children Enhanced recovery after surgery Clinical pathways Pain therapy protocol
- Azhar RA, Bochner B, Catto J, Goh AC, Kelly J, Patel HD, Pruthi RS, Thalmann GN, Desai M. Enhanced recovery after urological surgery: a contemporary systematic review of outcomes, key elements, and research needs. Eur Urol. 2016;70(1):176–87.Google Scholar
- Basse L, Thorbol J, Lossl K, Kehlet H. Colonic surgery with accelerated rehabilitation or conventional care. Dis Colon Rectum. 2004;47(3):271–7; discussion 277–8.Google Scholar
- Bond-Smith G, Belgaumkar AP, Davidson BR, Gurusamy KS. Enhanced recovery protocols for major upper gastrointestinal, liver and pancreatic surgery. Cochrane Database Syst Rev. 2016;2:CD011382.Google Scholar
- Büttner W, Finke W, Hilleke M, Reckert S, Vsianska L, Brambrink A. Development of an observational scale for assessment of postoperative pain in infants. Anesthesiol Intensivmed Notfallmed Schmerzther. 1998;33(6):353–6.Google Scholar
- Husted H, Otte KS, Kristensen BB, Kehlet H. Fast-track revision knee arthroplasty. A feasibility study. Acta Orthopaedica. 2011;82(4):438–40.Google Scholar
- Kehlet H. Fast-track surgery - an update on physiological care principles to enhance recovery. Langenbeck's Archives of Surgery. 2011;396(5):585–90.Google Scholar
- Leeds IL, Boss EF, George JA, Strockbine V, Wick EC, Jelin EB. Preparing enhanced recovery after surgery for implementation in pediatric populations. J Pediatr Surg. 2016;51(12):2126–9.Google Scholar
- Mohamed M, Hollins G, Eissa M. Experience in performing pyelolithotomy and pyeloplasty in children on day-surgery basis. Urology. 2004;64(6):1220–2.Google Scholar
- Moller C, Kehlet H, Friland SG, Schouenborg LO, Lund C, Ottesen B. Fast track hysterectomy. Eur J Obstet Gynecol Reprod Biol. 2001;98:18–22.Google Scholar
- Patel RI, Verghese ST, Hannallah RS, Aregawi A, Patel KM. Fast-tracking children after ambulatory surgery. Anesth Analg. 2001;92(4):918–22.Google Scholar
- Pearson KL, Hall NJ. What is the role of enhanced recovery after surgery in children? A scoping review. Pediatr Surg Int. 2016;33(1):43–51.Google Scholar
- Spanjersberg WR, Reurings J, Keus F, van Laarhoven CJ. Fast track surgery versus conventional recovery strategies for colorectal surgery. Cochrane Database Syst Rev. 2011;16(2):CD007635.Google Scholar
- Vegunta RK, Ali A, Wallace LJ, Switzer DM, Pearl RH. Laparoscopic appendectomy in children: technically feasible and safe in all stages of acute appendicitis. Am Surg. 2004;70(3):198–201; discussion 201–2.Google Scholar
- Vricella LA, Dearani JA, Gundry SR, Razzouk AJ, Brauer SD, Bailey LL. Ultra fast track in elective congenital cardiac surgery. Ann Thorac Surg. 2000;69(3):865–71.Google Scholar
- Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ. 2001;322(7284):473–6.Google Scholar