Enhanced Recovery After Surgery Pathways in Pediatric Thoracic Surgery: A Scoping Review.

BACKGROUND

Pediatric thoracic surgery is a field with a high risk of postoperative complications and a complex recovery process, requiring effective care models that support rapid and safe patient recovery.

OBJECTIVE

This study aims to systematically map the existing literature on ERAS (Enhanced Recovery After Surgery) protocols in pediatric thoracic surgery, to identify the reported protocol components and outcome measures, and to determine knowledge gaps for future research.

METHODS

A scoping review was conducted according to the six-stage framework of the Joanna Briggs Institute and reported in line with the PRISMA-ScR guidelines. A comprehensive literature search was performed in PubMed, Web of Science, and Scopus databases in February 2026. Studies examining ERAS protocols in pediatric thoracic surgery and reporting clinical and psychosocial outcomes were included. Two researchers independently extracted the data and synthesized them using thematic analysis.

RESULTS

A total of 7 studies were included in the scoping review. The most frequently evaluated components of ERAS protocols were early mobilization, multimodal analgesia, and early feeding, and these practices were important for shortening hospital length of stay, optimizing pain control, and supporting clinical efficiency without increasing complication rates. Although most studies were retrospective and single-center, ERAS was shown to be feasible when implemented through multidisciplinary teams and safe in terms of short-term clinical outcomes. However, patient-reported and long-term psychosocial outcomes remain limited.

CONCLUSION

ERAS protocols in pediatric thoracic surgery are feasible and safe in terms of short-term clinical outcomes and can be effective with multidisciplinary team coordination. Future multicenter, prospective, and standardized studies are needed to evaluate patient-reported and long-term outcomes.