Enhanced recovery in children: how could we go further?

Initially described for colorectal surgery,1 the benefits of ERAS are now well demonstrated in several surgical specialties for adults.2 The application of ERAS guidelines is the key to reduce hospital length of stay and cost through early mobilization, early feeding and early discharge.3 The implementation of ERAS in adults is a success, but this is not yet the case in pediatric surgery. [...]a study recently applied an 18-point ERAS program for colorectal pediatric elective surgery.8 Thanks to the ERAS protocol, the median number of assisted recovery procedures received per patient increased from 5 to 11, while the median length of stay significantly decreased from 5 to 3 days. The answer can be found within the peculiarities of pediatric surgery: (1) the predominance of outpatient surgery, (2) the low postoperative mortality rate, (3) the wide variety of populations ranging from newborns to young adults, as well as (4) the role of parents and child psychology in the success of this type of programs. [...]a prospective implementation study of this protocol is currently underway in 18 hospitals (Clinical Trials number NCT04060303).