Gastrointestinal Surgery Department, Santa Marcelina Itaquera Hospital, Rua Santa Marcelina, 177, 5 D, Vila Carmosina, São Paulo, SP, 08270-085, Brazil.
Mathematics and Statistics Centre, Federal Institute of the State of Goias, Rio Verde, GO, Brazil.
Obes Surg. 2021 Apr;31(4):1612-1617. doi: 10.1007/s11695-020-05168-x. Epub 2021 Jan 19.
The global prevalence of obesity and increase in bariatric surgeries are burdening the healthcare system. Enhanced recovery postoperative protocols are associated with a reduction in hospitalization costs and length of stay (LOS) and may be an alternative to reduce public health expenses.
To assess the impact of implementing a customized Enhanced Recovery After Bariatric Surgery (ERABS) protocol on hospitalization costs (HC), LOS, and complication rates.
Santa Marcelina Hospital, São Paulo, Brazil.
A retrospective electronic health record analysis of patients who underwent laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy and who were cared for within a clinical pathway (CP) protocol (Jan. 2016-Aug. 2018) or after implementation of an ERABS protocol (Aug. 2018-Jun. 2019). The LOS, HC, and complication, readmission, and reoperation rates were compared between the two groups.
Eighty-two patients were included in the study (CP, 56, 87.5% women; ERABS, 26, 92.3% women). Hospital LOS and total HC decreased significantly by 32.5% and 15.2%, respectively (both, p < 0.05), after implementation of ERABS. There were no significant differences in 30-day readmission, complication, or reoperation rates.
The implementation of a standardized enhanced recovery program resulted in reduced LOS and HC without an increase in perioperative morbidity. The ERABS protocol is cost-effective and can help ease the healthcare burden.
肥胖症在全球的流行和减重手术的增加给医疗保健系统带来了负担。强化康复术后方案与降低住院费用和住院时间（LOS）相关，可能是降低公共卫生支出的一种替代方法。
评估实施定制的减重手术后强化康复（ERABS）方案对住院费用（HC）、住院时间和并发症发生率的影响。
巴西圣保罗圣马塞利纳医院。
对接受腹腔镜 Roux-en-Y 胃旁路术或腹腔镜袖状胃切除术并在临床路径（CP）方案（2016 年 1 月至 2018 年 8 月）或 ERABS 方案实施后（2018 年 8 月至 2019 年 6 月）接受治疗的患者进行回顾性电子病历分析。比较两组的住院时间、住院费用和并发症、再入院和再次手术率。
本研究共纳入 82 例患者（CP 组 56 例，87.5%为女性；ERABS 组 26 例，92.3%为女性）。实施 ERABS 后，住院时间和总 HC 分别显著缩短 32.5%和 15.2%（均 p<0.05）。30 天再入院、并发症或再次手术率无显著差异。
实施标准化强化康复方案可降低 LOS 和 HC，而不会增加围手术期发病率。ERABS 方案具有成本效益，有助于减轻医疗保健负担。
