Gálvez-Gallo Griselda, Plascencia-Posada Francisco J, Cárdenas-Figueroa José A, Gutiérrez-Álvarez Guillermo, Gutiérrez-Gómez José A, Gallardo-Vázquez Carlos A
Clínica de Cirugía Bariátrica y Enfermedades Metabólicas, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara Jalisco, México.
Cir Cir. 2020;88(2):194-199. doi: 10.24875/CIRU.19001199.
Enhanced recovery after bariatric surgery (ERABS) protocols involve a series of multimodal perioperative procedures based on evidence designed to reduce physiological stress, improve recovery, and reduce costs on medical attention by decreasing length of hospital stay (length of stay [LOS]).
The objective of the study was to report the viability and results of the ERABS application in a reference bariatric center.
A prospective, observational, and descriptive study on bariatric procedures conducted over 12 months in the ERABS context which includes pre-procedure, intraprocedure, and post-procedure measures. The collected data include demographic data, comorbidity, morbimortality, LOS, and readmission to hospital.
Sixty-four patients within a median of 38.8 ± 9.5 years and 44.1 ± 6.20 kg/m BMI underwent surgery. Fifty-five (85.93%) were Roux-en-Y gastric bypass (RYGB) cases and 9 (14.06%) were sleeve gastrectomy (SG). Related comorbidities were hypertension 37%, diabetes 34%, dyslipidemia 23%, and obstructive sleep apnea 21%. Two (3.12%) patients developed post-operative morbidity (respiratory and thromboembolic complications). LOS for RYGB was 1.16 ± 0.97 and 1 ± 0 days for SG. The successful discharge rate on the 1 day after procedure was 96% and 100%, respectively. Readmission to hospital within a 30-day period presented itself on 4 patients (6.25%).
Applying ERABS protocols is feasible, safe, morbidity low, LOS acceptable, and a low readmission rate within 30 days.
减重手术后的加速康复（ERABS）方案涉及一系列基于证据的多模式围手术期程序，旨在减轻生理应激、促进康复，并通过缩短住院时间（住院时长[LOS]）降低医疗费用。
本研究的目的是报告ERABS方案在一家参考减重中心应用的可行性及结果。
在ERABS背景下，对12个月内进行的减重手术进行前瞻性、观察性和描述性研究，包括术前、术中和术后措施。收集的数据包括人口统计学数据、合并症、病死情况、住院时长和再入院情况。
64例患者接受了手术，年龄中位数为38.8±9.5岁，体重指数为44.1±6.20kg/m²。其中55例（85.93%）为Roux-en-Y胃旁路术（RYGB），9例（14.06%）为袖状胃切除术（SG）。相关合并症包括高血压37%、糖尿病34%、血脂异常23%和阻塞性睡眠呼吸暂停21%。2例（3.12%）患者出现术后并发症（呼吸和血栓栓塞并发症）。RYGB的住院时长为1.16±0.97天，SG为1±0天。术后第1天的成功出院率分别为96%和100%。30天内有4例患者（6.25%）再次入院。
应用ERABS方案是可行、安全的，并发症发生率低，住院时长可接受，30天内再入院率低。
