Aref Hager, Yunus Tahir, Farghaly Moheyeldin, ElDahshan Yasser, Khan Haseeb Javed, Alsaadi Dalia, Jacobo Francis Albert A, Ahmed Ayan, Mohamed Amel, Saber Ali Y, Ali Khairia, Alefranji Farah, Miranda Edilberta, Dakkak Omar
Department of Surgery, Andalusia Group Hospital, Jeddah, Saudi Arabia.
Department of Surgery, Evercare Hospital, Lahore, Pakistan.
BMC Gastroenterol. 2025 Aug 23;25(1):615. doi: 10.1186/s12876-025-04036-1.
The burden of obesity in Saudi Arabia is partly addressed with Laparoscopic Sleeve Gastrectomy (LSG), a bariatric surgical option, but perioperative complications and prolonged hospital stays persist. Enhanced Recovery After Surgery (ERAS) aims to improve postoperative outcomes.
To compare the peri-operative LSG outcomes among patients receiving ERAS and conventional bariatric procedures (non-ERAS).
A prospective cohort study design involving patients receiving conventional LSG care (non-ERAS) (n = 50) and those receiving ERAS protocol (n = 44) at International Medical Centre, Jeddah, Saudi Arabia. The ERAS protocol consisted of preoperative, intraoperative, and postoperative components, including patient education, fluid management, early mobilization, and pain management. Outcomes were compared between the two groups in terms of length of stay, postoperative ambulation, Clavien-Dindo graded postoperative complications, 30-day readmission, mortality and healthcare costs, followed by a five-year follow-up.
In total the number of participants was 94 patients. The ERAS group had a slightly shorter length of stay (2.05 days vs. 2.20 days) and significantly lower healthcare costs (SAR43,337 vs. SAR46,040, p < 0.05) compared to the non-ERAS group. The ERAS group had a lower incidence of postoperative Clavien-Dindo-graded complications, including wound infection, atelectasis, and pneumonia. The total length of the surgical procedure did not differ significantly (p < 0.05). Remarkably, 100% of patients in the ERAS group were out-of-bed on postoperative day (POD) zero compared to only 25% in the non-ERAS group. On the day of the operation, a greater percentage of patients in the ERAS group (58%) began oral intake than in the conventional care group (42%). There were no observable statistical differences in analgesic benefits in both groups (p = 0.543), 6 h after discharge from the post-anaesthesia care unit and at POD 1 (p = 0.08). At 5-year follow-up, the ERAS group had a better prognosis with fewer complications. At 5-year follow-up, a higher percentage of the ERAS group did not report any complication compared to the non-ERAS group (61% vs. 51%).
Implementation of ERAS in LSG improved postoperative outcomes, including shorter length of stay, better mobilization, lower healthcare costs, and fewer complications. This demonstrates the effectiveness of ERAS in LSG and provides valuable insights for improving perioperative bariatric care practices.
沙特阿拉伯的肥胖负担部分通过腹腔镜袖状胃切除术（LSG）这一减肥手术选项得到解决，但围手术期并发症和住院时间延长的问题仍然存在。术后加速康复（ERAS）旨在改善术后结果。
比较接受ERAS和传统减肥手术（非ERAS）的患者的LSG围手术期结果。
一项前瞻性队列研究设计，涉及在沙特阿拉伯吉达国际医疗中心接受传统LSG护理（非ERAS）的患者（n = 50）和接受ERAS方案的患者（n = 44）。ERAS方案包括术前、术中和术后部分，包括患者教育、液体管理、早期活动和疼痛管理。比较两组在住院时间、术后活动、Clavien-Dindo分级的术后并发症、30天再入院率、死亡率和医疗费用方面的结果，随后进行为期五年的随访。
总共有94名参与者。与非ERAS组相比，ERAS组的住院时间略短（2.05天对2.20天），医疗费用显著降低（43,337沙特里亚尔对46,040沙特里亚尔，p < 0.05）。ERAS组术后Clavien-Dindo分级并发症的发生率较低，包括伤口感染、肺不张和肺炎。手术总时长无显著差异（p < 0.05）。值得注意的是，ERAS组100%的患者在术后第0天就下床活动，而非ERAS组只有25%。在手术当天，ERAS组开始经口进食的患者比例（58%）高于传统护理组（42%）。两组在麻醉后护理单元出院后6小时和术后第1天的镇痛效果上没有明显的统计学差异（p = 0.543）（p = 0.08）。在5年随访时，ERAS组的预后更好，并发症更少。在5年随访时，与非ERAS组相比，ERAS组未报告任何并发症的比例更高（61%对51%）。
在LSG中实施ERAS可改善术后结果，包括缩短住院时间、更好的活动能力、降低医疗费用和减少并发症。这证明了ERAS在LSG中的有效性，并为改善围手术期减肥护理实践提供了有价值的见解。
