Sleeve Gastrectomy With or Without a Multimodal Perioperative Care. A Randomized Pilot Study

Area of Science:

• Bariatric Surgery
• Sleeve Gastrectomy
• Obesity Medicine

Background:

• Multimodal protocols show promise for enhancing postoperative recovery.
• Evaluating the impact of a multimodal protocol on clinical outcomes, insulin resistance, and inflammatory response in morbidly obese patients undergoing sleeve gastrectomy is crucial.

Purpose of the Study:

• To assess the efficacy of the Acerto multimodal protocol in improving postoperative recovery for morbidly obese patients.
• To evaluate the protocol's influence on clinical results, insulin resistance, and inflammatory response following sleeve gastrectomy.

Main Methods:

• A pilot study involving 20 morbidly obese patients undergoing sleeve gastrectomy.
• Patients were divided into two groups: traditional care versus the Acerto protocol.
• Key metrics included inflammatory markers, insulin resistance indicators, hydration, nausea, vomiting, hypertension, and hospital stay duration.

Main Results:

• The Acerto protocol group experienced no postoperative hypertensive crises (p = 0.03) and reduced vomiting by 30% (p = 0.35).
• A significant reduction in hospital stay was observed, averaging 2 days compared to 3 days in the control group (p = 0.02).
• No significant differences were found between groups regarding inflammatory response and insulin resistance (p > 0.05).

Conclusions:

• The Acerto multimodal protocol appears safe for morbidly obese patients undergoing sleeve gastrectomy.
• The protocol effectively reduced hypertensive complications and shortened postoperative hospital stays.
• No significant improvement in postoperative insulin resistance or acute-phase inflammatory response was noted.