TY - JOUR T1 - Enhanced recovery in children: how could we go further? JF - World Journal of Pediatric Surgery JO - World Jnl Ped Surgery DO - 10.1136/wjps-2021-000288 VL - 4 IS - 2 SP - e000288 AU - Jean-Philippe Salaün AU - Claude Ecoffey AU - Gilles Orliaguet Y1 - 2021/04/01 UR - http://wjps.bmj.com/content/4/2/e000288.abstract N2 - The concept of enhanced recovery after surgery (ERAS) has been established in adult surgery since the 1990s, starting with Kehlet’s studies on colorectal surgery. ERAS is based on the premise that patient postoperative outcome can be improved through the modulation of the physiological response to surgical stress. This multimodal approach begins in the preoperative period and continues both intraoperatively and postoperatively in the form of an overall rehabilitation plan. Since then, the majority of adult surgical specialties have set up ERAS guidelines. Nevertheless, the scientific literature on pediatric ERAS has not followed the same dynamic. The question of how to go further in pediatric ERAS therefore should be considered. It is likely that part of the answer lies in the peculiarities of pediatrics. To enable the development of an ambitious pediatric ERAS, a collaborative and multidisciplinary effort involving clinicians, parents and their children must be implemented.ERAS is a multidisciplinary approach to patient management in the perioperative period aimed at the rapid recovery ad integrum of the patient’s functional condition. 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. The existing literature on pediatric ERAS is limited. Only five studies were included in a recent literature review.4 Among those studies, only 5.6 rehabilitation elements against 23.8 in the adult papers were found in the rehabilitation protocols. Kehlet insisted on the fact that all patients should be included in ERAS pathway.5 However, most pediatric ERAS studies have focused on healthy patient populations.6 … ER -