Ruiz-Tovar Jaime, Royo Pablo, Muñoz José L, Duran Manuel, Redondo Elisabeth, Ramirez Jose M
*Department of Surgery, Bariatric Surgery Unit, University Hospital Rey Juan Carlos, Madrid †Department of Surgery, Bariatric Surgery Unit, Clinical University Hospital Lozano Blesa, Zaragoza ‡Department of Anaesthesiology, General University Hospital Elche, Alicante.
Surg Laparosc Endosc Percutan Tech. 2016 Dec;26(6):439-443. doi: 10.1097/SLE.0000000000000323.
The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish fast track group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery.
A multicentric prospective pilot study was performed, including 125 consecutive patients undergoing bariatric surgery at 3 Spanish hospitals between January and June 2015, after the Spanish National ERAS protocol in bariatric surgery. Compliance with the protocol, morbidity, mortality, hospital stay, and readmission were evaluated.
Bariatric techniques performed included 68 Roux-en-Y gastric bypass (54.4%) and 57 laparoscopic sleeve gastrectomy (45.6%) cases. All surgeries were laparoscopically performed with conversion in only 1 case (0.8%). Median postoperative pain evaluated by visual analogic scale 24 hours after surgery was 2 (range, 0 to 5). Postoperative nausea or vomiting appeared in 7 patients (5.6%). Complications appeared in 6 patients (4.8%). The reoperation rate was 4%. The mortality rate was 0.8%. The median hospital stay was 2 days (range, 2 to 10 d) and readmission rate was 2.4%. The compliance of all the items of the protocol was achieved in 78.4% of the patients.
The Spanish National ERAS protocol is a safe issue with a high implementation rate. It can be recommended to establish this protocol to other institutions.
术后加速康复（ERAS）计划的核心是多模式方法，许多作者已证明其在快速减重手术中的安全性和可行性。根据这一概念，西班牙快速康复小组（ERAS Spain）制定了减重手术的多学科ERAS计划。本研究的目的是分析该西班牙国家ERAS方案在减重手术中的初步实施情况。
进行了一项多中心前瞻性试点研究，纳入了2015年1月至6月期间在西班牙3家医院连续接受减重手术的125例患者，这些手术遵循西班牙国家减重手术ERAS方案。评估了方案的依从性、发病率、死亡率、住院时间和再入院情况。
实施的减重技术包括68例 Roux-en-Y胃旁路术（54.4%）和57例腹腔镜袖状胃切除术（45.6%）。所有手术均通过腹腔镜进行，仅1例（0.8%）转为开腹手术。术后24小时通过视觉模拟评分法评估的中位术后疼痛为2分（范围为0至5分）。7例患者（5.6%）出现术后恶心或呕吐。6例患者（4.8%）出现并发症。再次手术率为4%。死亡率为0.8%。中位住院时间为2天（范围为2至10天），再入院率为2.4%。78.4%的患者实现了方案所有项目的依从性。
西班牙国家ERAS方案安全性良好且实施率高。可推荐其他机构采用该方案。
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