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Invited commentary on Moon, et al: An enhanced recovery after surgery protocol in children who undergo nephrectomy for Wilms tumor safely shortens hospital stay

      Since 1999, adult Enhanced Recovery After Surgery (ERAS) protocols have been improving outcomes for surgery patients [
      • Kehlet H.
      • Mogensen T.
      Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme.
      ]. By 2008, several early ERAS articles were written documenting improvements in the care of colorectal, bladder, pancreatic and liver cancer patients [
      • King P.M.
      • Blazeby J.M.
      • Ewings P.
      • et al.
      The influence of an enhanced recovery programme on clinical outcomes, costs and quality of life after surgery for colorectal cancer.
      ,
      • Arumainayagam N.
      • McGrath J.
      • Jefferson K.P.
      • Gillatt D.A.
      Introduction of an enhanced recovery protocol for radical cystectomy.
      ,
      • Wichmann M.W.
      • Roth M.
      • Jauch K.W.
      • Bruns C.J.
      A prospective clinical feasibility study for multimodal "fast track" rehabilitation in elective pancreatic cancer surgery.
      ,
      • Van Dam R.M.
      • Hendry P.O.
      • Coolsen M.M.
      Enhanced Recovery After Surgery (ERAS) Group
      Initial experience with a multimodal enhanced recovery programme in patients undergoing liver resection.
      ]. These adult oncology reports demonstrated a decrease in length of stay [LOS] without an increase in complications or return to the system [ROS]. Patients who received minimally invasive surgery [MIS] as part of the ERAS protocol demonstrated improvements in the quality of life [QOL] as they recovered more quickly. In addition, ERAS patients had evidence of decreased stress response, and an earlier return to an anabolic state with positive nitrogen balance compared to those managed traditionally [
      • Ljungqvist O.
      • Scott M.
      • Fearon K.C.
      Enhanced recovery after surgery: a review.
      ]. Thus, the benefits of ERAS were brought to the surgical oncology world, helping people with cancer recover more quickly.
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