Case Control Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2025; 17(6): 105739
Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.105739
Application of enhanced recovery after surgery in perioperative care of infants and children with Hirschsprung disease
Mi-Yan Wang, Xiao-Hong Chen, Xiao-Chun He, Zhou-Jian Yang, Yu-Wei Yang, Jian Yang, Hui-Lin He
Mi-Yan Wang, Xiao-Chun He, Zhou-Jian Yang, Jian Yang, Hui-Lin He, Department of Pediatric Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
Xiao-Hong Chen, Yu-Wei Yang, Department of Laboratory Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
Co-first authors: Mi-Yan Wang and Xiao-Hong Chen.
Co-corresponding authors: Zhou-Jian Yang and Yu-Wei Yang.
Author contributions: Chen XH and Wang MY contributed equally as co-first authors; Yang YW and Yang ZJ contributed equally as co-corresponding authors; Wang MY and Yang YW conceived and designed the experiments and corrected the manuscript; Chen XH wrote the paper; Yang ZJ, Yang J, He HL, and He XC performed the experiments; Yang YW was the guarantor; and all authors reviewed the manuscript.
Supported by the Project of Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 2021YJ005; and the Science & Technology Department of Sichuan Province, China, No. 2019YJ0701.
Institutional review board statement: This study received written approval from the Ethics Committee of Mianyang Central Hospital (approval No. P2021092, date August 27, 2021), and was performed in accordance with the Declaration of Helsinki.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Wei Yang, Professor, Department of Laboratory Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 12 Changjia Lane, Jiedong Street, Fucheng District, Mianyang 621000, Sichuan Province, China. yyw318@sc-mch.cn
Received: February 6, 2025
Revised: April 7, 2025
Accepted: May 13, 2025
Published online: June 27, 2025
Processing time: 114 Days and 5 Hours
Abstract
BACKGROUND

Enhanced recovery after surgery (ERAS) represents an innovative, protocol-driven perioperative care program designed to optimize patient outcomes. However, its application and efficacy in infants and children with Hirschsprung disease (HD) remain underexplored.

AIM

To delve into the impact of ERAS on perioperative recovery and the overall medical experience in HD infants and children.

METHODS

Thirty-eight infants and children with HD who received the Soave surgical procedure were enrolled in this case-control study. According to age- and sex-stratified single-blind randomized tables, 20 cases received ERAS treatment (ERAS group) and 18 cases received conventional treatment (control group). The two treatments were then compared in terms of perioperative recovery and medical experience.

RESULTS

Significant differences were observed in pain scores at awakening (4.2 ± 1.3 vs5.2 ± 1.2, t = 2.516, P = 0.017) and pain duration (85.69 ± 7.46 hours vs 67.00 ± 8.56 hours, t = 7.139, P < 0.001) between the ERAS and control group. The recovery of bowel movement was earlier in the ERAS group than in the control group (borborygmus time: 33.63 ± 9.83 hours vs 44.69 ± 16.85 hours, t = 2.501, P = 0.017; feeding time: 36.63 ± 9.55 hours vs 49.36 ± 16.99 hours, t = 2.884, P = 0.007; anal catheter indwelling time: 75.83 ± 13.80 hours vs 93.36 ± 20.65 hours, t = 3.104, P = 0.004), and fever duration (40.73 ± 14.42 hours vs 52.63 ± 18.69 hours, t = 2.211, P = 0.034). In the ERAS group, hospital stay was shorter (7.5 ± 0.9 days vs 8.3 ± 1.2 days) and the cost was lower (14203 ± 2381 yuan vs 16847 ± 3558 yuan). During the 1-month follow-up period, of the multiple postoperative complications observed, the occurrence of perianal dermatitis (PFisher = 0.016) and defecation dysfunction (PFisher = 0.027) were lower in the ERAS group than in the control group.

CONCLUSION

The ERAS protocol has the potential to profoundly enhance postoperative recovery and significantly elevate the overall comfort and quality of the medical experience, making it an indispensable approach that warrants widespread adoption. Continuous refinement through evidence-based practices is anticipated to further optimize its efficacy.

Keywords: Enhanced recovery after surgery; Hirschsprung disease; Infant and children; Perioperative period; Outcome; Complications

Core Tip: Nursing based on the concept of enhanced recovery after surgery (ERAS) effectively accelerates perioperative recovery and improves postoperative outcomes in children with Hirschsprung disease. Strategic implementation of the ERAS protocol throughout the preoperative, intraoperative, and postoperative phases is crucial for achieving expedited recovery. The ERAS protocol, which takes into account the needs and feelings of patients, can enhance patients’ medical experience by ensuring the provision of high-quality care.