WOFAPS 2025 8th World Congress of Pediatric Surgery

Sajeed Ali ¹, Imogen Seago ², PSTRN PSTRN ³

¹ Evelina London Children's Hospital, London, United Kingdom
² North West Anglia NHS Foundation Trust
³ Paediatric Surgical Trainees Research Network , United Kingdom

Purpose

We aimed to report advice provided after common paediatric surgical procedures including return to education and physical activity.

Methods

Multicentre prospective UK observational study of advice provided by surgeons post-operatively for select elective/emergency procedures. Outcomes of interest were whether advice was provided, method of this and content of advice.

Results

Across 10 centres, 113 children were included (n=30 orchidopexy, n=26 inguinal herniotomy/PPV ligation [henceforth n=56 groin surgery], n=19 scrotal exploration, n=17 circumcision/preputioplasty, n=12 laparoscopic inguinal-hernia repair, n=5 umbilical/epigastric hernia repair, n=4 laparoscopic appendicectomy).

97/113 (86%) children were male, and median age was 6 years (range 4 months–17 years). 94/113 children had no comorbidities.

Post-operative advice was provided by a consultant/attending (n=26), registrar/resident (n=65), SHO/junior resident (n=18), or FY1/intern (n=1). Overall, 32% children received verbal advice only, 7% received written advice (e.g. discharge summary/leaflet), and 59% received both verbal and written information. 1% received no post-operative advice.

There was wide variation of advice provided, including duration of regular analgesia, time to first shower/bath/swim, time to contact/non-contact physical activity, and time before restarting nursery/school (Table 1).

Regarding return to nursery/school, following groin surgery, 8/56 children were advised 1-3 days off, 18/56 advised 4-6 days, 6/56 advised 1-2 weeks and 24/56 received no advice. Following circumcision/preputioplasty, 4/17 children were advised 1-3 days off school, 6/17 advised 4-6 days, 1/17 1-2 weeks, 6/17 received no advice. Similar variation was seen across procedures

Conclusion

Variation in post-operative advice provided is evident, highlighting uncertainty amongst surgeons regarding optimal post-operative care. Better evidence is required to allow adequate recovery balanced against minimising impact to the family.