Enhanced Recovery After Surgery and next-day discharge after laparoscopic Roux-en-Y gastric bypass

Area of Science:

• Bariatric Surgery
• Surgical Outcomes
• Enhanced Recovery Protocols

Background:

• Laparoscopic Roux-en-Y gastric bypass (LRYGB) often results in prolonged hospital stays.
• Enhanced Recovery After Surgery (ERAS) protocols aim to shorten recovery and facilitate early discharge.

Purpose of the Study:

• To evaluate the impact of an ERAS protocol and a short-stay unit on LRYGB patient recovery.
• To assess the safety and feasibility of next-day discharge after LRYGB.

Main Methods:

• Retrospective review of prospectively collected data from 439 LRYGB patients (Nov 2017-Dec 2020).
• Postoperative evaluation within 16-21 hours; patients advised to stay within 1 hour of the center for 7 days.
• Analysis of length of stay, emergency department visits, and readmissions within 30 days.

Main Results:

• 94.8% of patients were discharged on postoperative day 1; 1.8% on day 2.
• 2.7% of patients required transfer for prolonged care, mainly due to delayed hemorrhage or complex procedures.
• 30-day emergency department presentation rate was 10.3%; 7-day readmission was 2.7%; 30-day readmission was 4.1%.

Conclusions:

• An ERAS protocol facilitated safe next-day discharge for the vast majority of LRYGB patients.
• Readmission and emergency department presentation rates were consistent with current literature.
• Next-day discharge is feasible for appropriately selected LRYGB patients, optimizing postoperative care.