Enhanced recovery after surgery (ERAS) in pediatrics, a first-ever Canadian conference on the subject

to enhance the expertise of care providers for the benefit of patients and their families

Canada’s first-ever multidisciplinary conference on Enhanced Recovery after Surgery (ERAS) in pediatrics was held on April 28. The conference was part of the Enhanced Recovery project developed by the Mirella and Lino Saputo Foundation Chair in Pediatric Surgical Education and Patient and Family Centered Care, whose main objective is to improve the recovery of patients following surgery.

The Montreal Children’s Hospital and Shriners Hospital for Children – Canada have welcomed nearly 100 participants from across Quebec to attend lectures by speakers and experts from a variety of backgrounds, to learn about the essential ERAS principles and processes, the specific issues involved in its application in pediatrics, and the future and implementation of a pediatric ERAS culture in Quebec hospitals.

“This conference went beyond the walls of the Children’s to include participants from multiple children’s hospitals in Quebec, as well as all stakeholders, including the Ministère de la Santé et des Services sociaux du Québec (MSSS), members of hospital administrations, nursing, allied health professionals, foundations, and of course anesthesiologists and surgeons,” explains Sherif Emil,MD,CM,  Saputo Chair and ERAS Conference Chair. ” In doing so, we set the standard that we will move with ERAS together to benefit children everywhere in Quebec and beyond. The impact of the conference will far exceed the introduction of ERAS for one condition or in one hospital.”

ERAS is a particularly innovative approach that has a major impact on patients, first and foremost by forging closer ties between the medical profession and families, so as to offer the latter better support throughout their surgical journey. This impact had been highlighted in the ERAS protocol for children undergoing minimally invasive pectus excavatum repair (NUSS procedure), a protocol on which the Montreal Children’s Hospital and Shriners Hospitals for Children – Canada had jointly established as part of this project. The ERAS protocol was able to cut hospitalization after this procedure from approximately one week to a single night.

The impact of surgery on the child and his or her family is great, especially when recovery times are long and painful: “As a patient who underwent pectus surgery before the implementation of ERAS, I found it striking how my personal recovery was intricately intertwined with my family’s recovery. ” explains Daniel Chow, an attorney and current medical student who underwent a Nuss technique as a younger man, “The stress caused by my operation affected my family in various ways: my mother had to take time off work to care for me at home, and my father dedicated his time to stay with me in the hospital for upwards of 2 weeks. Witnessing their dedication, I couldn’t help but appreciate not only the immense strength it took for them to overcome all these difficulties, but also to entrust their child’s well-being to a surgeon. It must have been an incredibly challenging experience for them.”

This echoes the words of Dr. Emil, when he explains that “a child’s recovery is a family’s recovery.” Not only do ERAS techniques reduce post-operative narcotics and  shorten hospital stays, but they also have a tangible impact on families’ lives. What Daniel is hoping for now is that the network between patients, their families and the professionals who support them will be prioritized and expanded. “During a child’s surgery, there will always be moments of anticipation and stress, albeit shorter than before, that a family must overcome. Therefore, I believe it is crucial for healthcare professionals to emphasize the significance of family involvement in the recovery process, regardless of the procedure’s magnitude,” he states.

Following the conference, a story on the movement towards a pediatric ERAS culture was covered by CTV news.

It’s a safe bet that conferences like these will support the path that Dr. Emil and Daniel Chow want to see forged: enabling thousands of children and their families who will have to undergo surgery in the future to recover more quickly and be able to prepare for it more serenely.