Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of General Surgery

The concept of fast-track surgery using multimodal perioperative rehabilitation programs was introduced in the early 1990s. Fast-track surgery has been used for some general and cardiac surgery in children. Detailed data on the feasibility, safety and costs offast-track pediatric surgery are only just emerging. Patients and methods: Prospective data collection on all admissions meeting the inclusion criteria was carried out. Demographics, pain score, postoperative feeding, hospital stay,complications and readmissions weree valuated. Results: From August 2009 to December 2011,1024 patients were admitted for the following procedures:appendicectomy, closureofstoma,fundoplication, endo-anal pullthrough for Hirschsprung{u2019}s disease, hypospadias repair and repair of congenital diaphragmatic hernia. A total of 617(60.2%) were eligible for fast-track. Laparoscopy was done in 35.5% of cases. The median postoperative pain intensity was 3.Median start of feeds was 1.75 days postoperatively. Hospital stay was amedian of 3days. The overall complication rate was 7.6%. The overall readmission rate was 8.4%. Conclusions: Fast-track surgery is feasible in general pediatric surgery, across a wide range of procedures. The frequency of laparoscopy in this study was low

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