Presenter Status
Fellow
Abstract Type
QI
Primary Mentor
Tolulope Oyetunji
Start Date
12-5-2025 12:15 PM
End Date
12-5-2025 12:30 PM
Presentation Type
Oral Presentation
Description
Background/Purpose
Corrective surgery for Pectus Excavatum comes primarily via the Nuss procedure. Pain control contributes significantly to the postoperative length of stay (LOS). Optimization of pain control can be achieved in multiple ways in the form of an Enhanced Recovery After Surgery (ERAS) protocol. The purpose of our study is to assess the success of same-day discharge with a ERAS protocol for same-day discharge (SDD) of patients undergoing Pectus Excavatum repair.
Methods
A retrospective review of patients from August 2022 to August 2024 at a stand-alone tertiary care children’s hospital who underwent minimally invasive repair of Pectus Excavatum was performed. A protocol was initiated that involved early start times, pre-operative scopolamine patches and intra-operative ondansetron, hydromorphone, IV acetaminophen and ketorolac as well as thoracoscopic cryoablation for pain control. This cohort of patients was compared to patients managed in the year prior to implementation of this ERAS protocol which served as our control.
Results
75 patients were managed during our study period as compared to 37 in our control group. Since initiation of our ERAS protocol, 46 (61.3%) had a SDD in our study period compared to 0 in the control group which had a p-value of < 0.05. The median LOS in the study period was 18.2 hours compared to 27 hours in the control group, which also had a p-value of < 0.05. The control group had 3 (8.1%) patients return to the ER compared to 7 (7.9%) in the study group. The control group patients were secondary to pain while the study group had 3 presentations for pain, 3 for pleural effusions requiring drainage, 1 for a subcutaneous abscess.
Conclusion
ERAS protocol for SDD after Pectus Excavatum surgery is safe and feasible, without increased return to the hospital or readmission. Implementation of an ERAS protocol with a goal of SDD can help facilitate expedited discharge and significantly decrease hospital LOS.
Same Day Discharge Following Minimally Invasive Repair of Pectus Excavatum Following an ERAS Protocol
Background/Purpose
Corrective surgery for Pectus Excavatum comes primarily via the Nuss procedure. Pain control contributes significantly to the postoperative length of stay (LOS). Optimization of pain control can be achieved in multiple ways in the form of an Enhanced Recovery After Surgery (ERAS) protocol. The purpose of our study is to assess the success of same-day discharge with a ERAS protocol for same-day discharge (SDD) of patients undergoing Pectus Excavatum repair.
Methods
A retrospective review of patients from August 2022 to August 2024 at a stand-alone tertiary care children’s hospital who underwent minimally invasive repair of Pectus Excavatum was performed. A protocol was initiated that involved early start times, pre-operative scopolamine patches and intra-operative ondansetron, hydromorphone, IV acetaminophen and ketorolac as well as thoracoscopic cryoablation for pain control. This cohort of patients was compared to patients managed in the year prior to implementation of this ERAS protocol which served as our control.
Results
75 patients were managed during our study period as compared to 37 in our control group. Since initiation of our ERAS protocol, 46 (61.3%) had a SDD in our study period compared to 0 in the control group which had a p-value of < 0.05. The median LOS in the study period was 18.2 hours compared to 27 hours in the control group, which also had a p-value of < 0.05. The control group had 3 (8.1%) patients return to the ER compared to 7 (7.9%) in the study group. The control group patients were secondary to pain while the study group had 3 presentations for pain, 3 for pleural effusions requiring drainage, 1 for a subcutaneous abscess.
Conclusion
ERAS protocol for SDD after Pectus Excavatum surgery is safe and feasible, without increased return to the hospital or readmission. Implementation of an ERAS protocol with a goal of SDD can help facilitate expedited discharge and significantly decrease hospital LOS.
