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Enhanced Recovery After Surgery Protocol in Bariatric Surgery Leads to Decreased Complications and Shorter Length of

Lucas C Fair^1,2,3, Steven G Leeds^1,2,4, Edward P Whitfield⁴

¹Department of Minimally Invasive Surgery, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX, 75246, USA.

Obesity Surgery

|January 26, 2023

Abstract

Purpose:

Enhanced recovery after surgery (ERAS) programs have been shown in some specialties to improve short-term outcomes following surgical procedures. There is no consensus regarding the optimal perioperative care for bariatric surgical patients. The purpose of this study was to develop a bariatric ERAS protocol and determine whether it improved outcomes following surgery.

Materials And Methods:

An IRB-approved prospectively maintained database was retrospectively reviewed for all patients undergoing bariatric surgery from October 2018 to January 2020. Propensity matching was used to compare post-ERAS implementation patients to pre-ERAS implementation.

Results:

There were 319 patients (87 ERAS, 232 pre-ERAS) who underwent bariatric operations between October 2018 and January 2020. Seventy-nine patients were kept on the ERAS protocol whereas 8 deviated. Patients who deviated from the ERAS protocol had a longer length of stay when compared to patients who completed the protocol. The use of any ERAS protocol (completed or deviated) reduced the odds of complications by 54% and decreased length of stay by 15%. Furthermore, patients who completed the ERAS protocol had an 83% reduction in odds of complications and 31% decrease in length of stay. Similar trends were observed in the matched cohort with 74% reduction in odds of complications and 26% reduction in length of stay when ERAS was used.

Conclusions:

ERAS protocol decreases complications and reduces length of stay in bariatric patients.

Keywords:

Bariatric surgery Enhanced recovery after surgery (ERAS)Laparoscopic sleeve gastrectomy Roux-en-Y gastric bypass

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