{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:42:12Z","timestamp":1786650132640,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      Enhanced Recovery After Surgery (ERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      ) protocols aim to minimize surgical stress and accelerate recovery. In patients undergoing gastric transposition, modifications of ERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      may reduce complications, shorten hospital stay, and improve overall quality of life (QOL). Its application in pediatric esophageal replacement remains limited. We aimed to assess the outcomes of patients undergoing gastric transposition using a modified ERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      (mERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      ) protocol.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      This study included patients of long-gap Esophageal atresia\/ Tracheo-esophageal fistula (EA\/TEF) and pure esophageal atresia operated undergoing gastric transposition between January 2017 and May 2024. The retrospective group included patients managed with a conventional approach (non-ERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      group), and the prospective group was managed with mERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      bundles. The outcomes were compared, and QOL assessment was done using Quality of life of the infant (QUALIN) and Depression, Anxiety, and Stress Scale scores. Statistical analysis for categorical variables was done using the Chi-square\/Fisher\u2019s exact test. Nonparametric data were analyzed with the Wilcoxon rank-sum test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      compliance was high. The mERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      group showed a statistically significant reduction in days of ventilation (2.08 vs. 6.43 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0420), intensive care unit stay (8.82 vs. 21.08 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.016), and early start of feeding (2.75 vs. 7.15 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003). The length of hospital stay was shorter in the mERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      group (16.250 vs. 26.071 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.037). There was a significant improvement in the QOL of infants and parental satisfaction score (80% mERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      vs. 28.57% non-ERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      group).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Implementation of the mERAS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      protocol in gastric transposition surgery leads to early recovery, shorter hospitalization, improved QOL of infants, and improved satisfaction among the parents.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_147_25","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T11:00:29Z","timestamp":1767956429000},"page":"20-28","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Modified Enhanced Recovery After Surgery Protocols in Pediatric Gastric Transposition: Effects on Recovery and Outcomes"],"prefix":"10.4103","volume":"31","author":[{"given":"Mohit B.","family":"Chauhan","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Advanced Pediatric Centre, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin James","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Advanced Pediatric Centre, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muneer Abas","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Advanced Pediatric Centre, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani","family":"Dogra","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Advanced Pediatric Centre, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi Prakash","family":"Kanojia","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Advanced Pediatric Centre, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajni","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandhya","family":"Yaddanapudi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Bawa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Advanced Pediatric Centre, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailesh","family":"Solanki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Advanced Pediatric Centre, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jai Kumar","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Advanced Pediatric Centre, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/0022-3468(92)90322-X","article-title":"Gastric transposition for esophageal substitution in children","volume":"27","author":"Spitz","year":"1992","journal-title":"J Pediatr Surg"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s13312-015-0664-4","article-title":"Long-term complications of congenital esophageal atresia, single institution experience","volume":"52","author":"Koziarkiewicz","year":"2015","journal-title":"Indian Pediatr"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/0261-5614(94)90021-3","article-title":"Impact of nutritional support on the clinical outcome of the surgical patient","volume":"13","author":"Hill","year":"1994","journal-title":"Clin Nutr"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1093\/bja\/78.5.606","article-title":"Multimodal approach to control postoperative pathophysiology and rehabilitation","volume":"78","author":"Kehlet","year":"1997","journal-title":"Br J Anaesth"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.jss.2015.12.051","article-title":"Enhancing recovery in pediatric surgery: A review of the literature","volume":"202","author":"Shinnick","year":"2016","journal-title":"J Surg Res"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jpedsurg.2003.11.032","article-title":"Gastric transposition in children \u2013 A 21-year experience","volume":"39","author":"Spitz","year":"2004","journal-title":"J Pediatr Surg"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"110","DOI":"10.4103\/0971-9261.182582","article-title":"Pediatric esophageal substitution by gastric pull-up and gastric tube","volume":"21","author":"Choudhury","year":"2016","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"100129","DOI":"10.1016\/j.yjpso.2024.100129","article-title":"Enhanced recovery after surgery (ERAS\u00ae) novel protocol for management of esophageal replacement in children: A single surgeon\u2019s experience of 116 cases","volume":"6","author":"Saoji","year":"2024","journal-title":"J Paediatric Surg Open"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.jpedsurg.2022.11.015","article-title":"Goal-directed fluid therapy guided by plethysmographic variability index (PVI) versus conventional liberal fluid administration in children during elective abdominal surgery:A randomized controlled trial","volume":"58","author":"Mathew","year":"2023","journal-title":"J Pediatr Surg"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"4815","DOI":"10.1177\/0300060519865350","article-title":"Enhanced recovery after surgery in pediatric gastrointestinal surgery","volume":"47","author":"Gao","year":"2019","journal-title":"J Int Med Res"},{"key":"R12-20260420","doi-asserted-by":"crossref","first-page":"16","DOI":"10.13029\/aps.2025.31.1.16","article-title":"Early Versus delayed enteral feeding in children after intestinal anastomosis: A randomized controlled study","volume":"31","author":"Upreti","year":"2025","journal-title":"Adv Pediatr Surg"},{"key":"R13-20260420","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/00000658-198707000-00011","article-title":"Gastric transposition for esophageal replacement in children","volume":"206","author":"Spitz","year":"1987","journal-title":"Ann Surg"},{"key":"R14-20260420","first-page":"293","article-title":"The FLACC: A behavioral scale for scoring postoperative pain in young children","volume":"23","author":"Merkel","year":"1997","journal-title":"Pediatr Nurs"},{"key":"R15-20260420","first-page":"e15021","article-title":"Enhanced recovery after surgery (ERAS) protocol for pediatric patients undergoing abdominal surgery reduces postoperative pain and hospital stay","volume":"98","author":"Wu","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"R16-20260420","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/0005-7967(94)00075-U","article-title":"The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the beck depression and anxiety inventories","volume":"33","author":"Lovibond","year":"1995","journal-title":"Behav Res Ther"},{"key":"R17-20260420","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1007\/s12098-022-04132-0","article-title":"Translation, adaptation, and validation of Hindi version of quality of life of the infant (QUALIN) for use in infants and toddlers","volume":"90","author":"Devi","year":"2023","journal-title":"Indian J Pediatr"},{"key":"R18-20260420","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.jpedsurg.2014.05.026","article-title":"A two-center comparative study of gastric pull-up and jejunal interposition for long gap esophageal atresia","volume":"50","author":"Gallo","year":"2015","journal-title":"J Pediatr Surg"},{"key":"R19-20260420","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1097\/ALN.0b013e3181fc6e0a","article-title":"Prediction of postoperative pulmonary complications in a population-based surgical cohort","volume":"113","author":"Canet","year":"2010","journal-title":"Anesthesiology"}],"container-title":["Journal of Indian Association of Pediatric Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_147_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:03:54Z","timestamp":1786647834000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_147_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jiaps.jiaps_147_25","relation":{},"ISSN":["0971-9261","1998-3891"],"issn-type":[{"value":"0971-9261","type":"print"},{"value":"1998-3891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-05-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}