Fast Track Program in Conversion Bariatric Surgery, as Safe as in Primary Bariatric Surgery?

Area of Science:

• Bariatric Surgery
• Surgical Outcomes
• Patient Recovery Protocols

Background:

• The fast track (FT) surgery program aims to optimize patient recovery and reduce hospital stays after bariatric procedures.
• Evaluating the safety and efficacy of FT protocols in both primary and revisional bariatric surgeries is crucial for widespread adoption.

Purpose of the Study:

• To assess the safety of the FT surgery program for patients undergoing primary and revisional bariatric surgery.
• To identify factors influencing early discharge and predict readmission risks within the FT protocol.

Main Methods:

• A retrospective review of 730 morbidly obese patients who underwent bariatric surgery between 2016 and 2017.
• All patients were managed under a FT protocol with a target discharge of one night post-surgery.
• Primary endpoints included length of stay (LOS), while secondary endpoints were post-discharge contact, readmissions, and reinterventions within 30 days.

Main Results:

• Mean LOS was 1.3 days for primary procedures and 1.5 days for conversion procedures.
• Successful one-night discharge was achieved in 650 patients (89%).
• One-night discharge in conversion procedures was safe, with higher readmission rates (13%) compared to primary procedures (5.9%), but no significant difference in complications.

Conclusions:

• The FT surgery program is safe for one-night discharge in bariatric surgery, including conversion procedures.
• Conversion procedures under FT management are associated with increased readmission rates but similar surgical complication rates.
• Further investigation into predictive factors for readmission in conversion cases managed under FT protocols is warranted.