Experience with an Enhanced Recovery After Surgery (ERAS) Program for Bariatric Surgery: Comparison of MGB and LSG in 374 Patients

Obes Surg. 2017 Jul;27(7):1896-1900. doi: 10.1007/s11695-017-2694-6.

Abstract

Background: Strategic multidisciplinary protocols for "enhanced recovery after surgery" (ERAS) have demonstrated reductions in length of hospital stay (LOS), morbidity, and costs in conjunction with bariatric procedures.

Methods: We prospectively investigated the effectiveness and safety of an ERAS protocol with laparoscopic omega loop gastric bypass ("mini" gastric bypass, MGB) and LSG in morbidly obese patients.

Results: Average LOS was 1.24 days (range 1-14); 86.1% discharged on day 1; 96.9% by day 2, a value comparable or better than that of other ERAS studies vs standard care according to meta-analysis. Complications 2.9%; readmission 2.1%; reintervention 1.3%.

Conclusion: The program was equally safe with both procedures. Postoperative antithrombotic heparin does not appear necessary in low-risk patients. Bariatric surgical ERAS programs are evolving and not yet standardized.

Keywords: Bariatric surgery; ERAS; Enhanced recovery; LSG; Laparoscopic; MGB.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aftercare / methods
  • Aftercare / standards
  • Aged
  • Clinical Protocols*
  • Convalescence
  • Costs and Cost Analysis
  • Female
  • Gastrectomy* / economics
  • Gastrectomy* / methods
  • Gastric Bypass* / economics
  • Gastric Bypass* / methods
  • Humans
  • Laparoscopy
  • Length of Stay / economics
  • Male
  • Middle Aged
  • Morbidity
  • Obesity, Morbid / surgery*
  • Perioperative Care / methods*
  • Perioperative Care / standards
  • Postoperative Period
  • Prospective Studies
  • Young Adult