Department of Minimally Invasive Surgery, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX, 75246, USA.
Center for Advanced Surgery, Baylor Scott and White Health, 3417 Gaston Ave Suite 965, Dallas, TX, 75246, USA.
Obes Surg. 2023 Mar;33(3):743-749. doi: 10.1007/s11695-023-06474-w. Epub 2023 Jan 26.
Enhanced recovery after surgery (ERAS) programs have been shown in some specialties to improve short-term outcomes following surgical procedures. There is no consensus regarding the optimal perioperative care for bariatric surgical patients. The purpose of this study was to develop a bariatric ERAS protocol and determine whether it improved outcomes following surgery.
An IRB-approved prospectively maintained database was retrospectively reviewed for all patients undergoing bariatric surgery from October 2018 to January 2020. Propensity matching was used to compare post-ERAS implementation patients to pre-ERAS implementation.
There were 319 patients (87 ERAS, 232 pre-ERAS) who underwent bariatric operations between October 2018 and January 2020. Seventy-nine patients were kept on the ERAS protocol whereas 8 deviated. Patients who deviated from the ERAS protocol had a longer length of stay when compared to patients who completed the protocol. The use of any ERAS protocol (completed or deviated) reduced the odds of complications by 54% and decreased length of stay by 15%. Furthermore, patients who completed the ERAS protocol had an 83% reduction in odds of complications and 31% decrease in length of stay. Similar trends were observed in the matched cohort with 74% reduction in odds of complications and 26% reduction in length of stay when ERAS was used.
ERAS protocol decreases complications and reduces length of stay in bariatric patients.
在某些专业中，手术后恢复增强（ERAS）方案已被证明可以改善手术程序后的短期结果。对于肥胖症患者的最佳围手术期护理尚无共识。本研究的目的是制定肥胖症 ERAS 方案，并确定其是否可以改善手术后的结果。
对 2018 年 10 月至 2020 年 1 月期间接受减重手术的所有患者进行了经机构审查委员会批准的前瞻性维护数据库的回顾性分析。采用倾向评分匹配比较 ERAS 实施前后的患者。
在 2018 年 10 月至 2020 年 1 月期间，有 319 名患者（87 名 ERAS，232 名 ERAS 前）接受了减重手术。有 79 名患者遵守了 ERAS 方案，而 8 名患者偏离了该方案。与完成方案的患者相比，偏离 ERAS 方案的患者住院时间更长。使用任何 ERAS 方案（完成或偏离）可使并发症的几率降低 54%，住院时间缩短 15%。此外，完成 ERAS 方案的患者发生并发症的几率降低了 83%，住院时间缩短了 31%。在匹配队列中也观察到了类似的趋势，使用 ERAS 可使并发症的几率降低 74%，住院时间缩短 26%。
ERAS 方案可降低肥胖症患者的并发症发生率并缩短住院时间。
