Department of Surgery, OLVG Hospital, Amsterdam, The Netherlands.
Department of Surgery, Amsterdam UMC, Amsterdam, The Netherlands.
Obes Surg. 2023 Aug;33(8):2317-2323. doi: 10.1007/s11695-023-06697-x. Epub 2023 Jun 22.
Same-day discharge (SDD) after bariatric surgery is increasingly being performed and is safe with careful patient selection. However, detecting early complications during the first postoperative days can be challenging. We developed a postoperative care protocol for these patients and aimed to evaluate its effectiveness in detecting complications and monitoring patient recovery.
A single-center retrospective observational study was conducted with patients with who underwent Roux-en-Y Gastric Bypass (RYGB) with successful SDD. The study evaluated the effectiveness of the safety net that included simple remote monitoring with a pulsoximeter and thermometer, a phone consultation on postoperative day (POD) 1, and a physical consultation on POD 2-4. Furthermore, an analysis was performed on various factors including pain scores, painkiller usage, and incidences of nausea and vomiting on POD 1.
In this study, 373 consecutive patients were included, of whom 19 (5.1%) were readmitted until POD 4. Among these, 12 patients (3.2%) reached out to the hospital themselves, while 7 (1.9%) were readmitted after phone or physical consultations. Ten of the readmitted patients had tachycardia. On POD 1, the mean numeric rating scale was 4 ± 2, and 96.6% of the patients used acetaminophen, 35.5% used naproxen, and 9.7% used oxynorm. Of the patients, 13.9% experienced nausea and 6.7% reported vomiting.
A postoperative care protocol for SDD after RYGB, comprising simple remote monitoring along with a phone consultation on POD 1 and a physical checkup on POD 2-4, was effective in monitoring patient recovery and detecting all early complications.
减重手术后的当日出院（SDD）越来越多地被实施，并且在仔细选择患者的情况下是安全的。然而，在术后头几天检测早期并发症可能具有挑战性。我们为这些患者制定了术后护理方案，并旨在评估其在检测并发症和监测患者康复方面的有效性。
对成功行 RYGB 并实现 SDD 的患者进行了单中心回顾性观察性研究。该研究评估了安全网的有效性，该安全网包括使用脉搏血氧仪和温度计进行简单的远程监测、术后第 1 天进行电话咨询以及术后第 2-4 天进行身体检查。此外，还对包括疼痛评分、止痛药使用情况以及术后第 1 天恶心和呕吐发生率在内的各种因素进行了分析。
本研究共纳入了 373 例连续患者，其中 19 例（5.1%）在术后第 4 天前被重新收治。其中，12 例（3.2%）患者自行前往医院，7 例（1.9%）患者在电话或身体检查后被重新收治。10 例重新收治的患者有心律过速。术后第 1 天，平均数字评分量表为 4 ± 2，96.6%的患者使用对乙酰氨基酚，35.5%的患者使用萘普生，9.7%的患者使用羟考酮。13.9%的患者出现恶心，6.7%的患者报告呕吐。
RYGB 术后 SDD 的术后护理方案，包括术后第 1 天进行简单的远程监测、电话咨询以及术后第 2-4 天进行身体检查，有效地监测了患者的康复情况并检测到了所有早期并发症。
