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美国代谢与减重外科学会:Roux-en-Y胃旁路术后护理路径指南

American Society for Metabolic and Bariatric Surgery: postoperative care pathway guidelines for Roux-en-Y gastric bypass.

作者信息

Edwards Michael A, Powers Kinga, Vosburg R Wesley, Zhou Randal, Stroud Andrea, Obeid Nabeel R, Pilcher John, Levy Shauna, McArthur Karina, Basishvili Givi, Rosenbluth Amy, Petrick Anthony, Lin Henry, Kindel Tammy

机构信息

Department of Surgery, Mayo Clinic, Jacksonville, Florida.

Department of Surgery, Stony Brook Medicine, Stony Brook, New York.

出版信息

Surg Obes Relat Dis. 2025 May;21(5):523-536. doi: 10.1016/j.soard.2025.01.005. Epub 2025 Jan 24.

Abstract

BACKGROUND

Clinical care pathways and guidelines help guide and provide structure to clinicians and providers to improve healthcare delivery and quality. The Quality Improvement and Patient Safety (QIPS) Committee of the American Society for Metabolic and Bariatric Surgery (ASMBS) has previously published care pathways for the performance of laparoscopic sleeve gastrectomy (LSG), preoperative care of patients undergoing Roux-en-Y gastric bypass (RYGB), and most recently, intraoperative care of patients undergoing RYGB.

OBJECTIVES

This current RYGB care pathway guideline was created to address postoperative care guidance.

SETTING

Academic Health Center.

METHODS

For this systematic review, PubMed queries were performed from January 1979 to December 2019. Follow-up queries were performed from January 2020 to July 2024. Peer-reviewed publications were reviewed according to the level of evidence (LoE) regarding specific key questions developed by the QIPS Committee and working group for this pathway.

RESULTS

Evidence-based recommendations are made for the postoperative care of patients undergoing RYGB, including recommendations for early postoperative care, postoperative medication management, and long-term postoperative surveillance.

CONCLUSIONS

This document may provide a structure to providers based on current evidence for the postoperative care of patients with overweight or obesity undergoing RYGB.

摘要

背景

临床护理路径和指南有助于指导临床医生和医疗服务提供者,并为其提供框架,以改善医疗服务的提供和质量。美国代谢与减重外科学会(ASMBS)的质量改进与患者安全(QIPS)委员会此前已发布了腹腔镜袖状胃切除术(LSG)的护理路径、接受Roux-en-Y胃旁路术(RYGB)患者的术前护理,以及最近的接受RYGB患者的术中护理。

目的

制定本当前的RYGB护理路径指南以解决术后护理指导问题。

地点

学术健康中心。

方法

对于本系统评价,于1979年1月至2019年12月进行了PubMed检索。于2020年1月至2024年7月进行了随访检索。根据QIPS委员会和该路径工作组针对特定关键问题制定的证据水平(LoE)对同行评审的出版物进行了审查。

结果

针对接受RYGB患者的术后护理提出了基于证据的建议,包括术后早期护理、术后药物管理和术后长期监测的建议。

结论

本文档可为医疗服务提供者基于当前证据为接受RYGB的超重或肥胖患者提供术后护理提供一个框架。

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