Original articleEnhanced recovery after surgery (ERAS) in one-anastomosis gastric bypass surgery: a matched-cohort study
Section snippets
Methods
Between October 2014 and April 2017, data were prospectively collected on all consecutive morbidly obese patients undergoing OAGB by a single surgeon who had a single co-worker anesthesiologist. The team used a conventional approach to perioperative care between October 2014 and March 2015. They then changed the approach to the ERAS pathway. The ERAS pathway was adapted from the works of Awad et al. [5] and Lemanu et al. [9]. The characteristics of the conventional approach and the ERAS pathway
Results
The characteristics of the patients in both groups are described in Table 2. Both groups were homogeneous for age, body mass index, co-morbidities, OT, complications, and mortality. The only difference between the groups was the sex ratio. The planned discharge on POD4 was achieved for all patients in group 1. All were admitted on the day before surgery, resulting in a total mean LOS of 5 days. In group 2, the planned discharge on POD1 was achieved for 188 patients (87%). One of the remaining
Discussion
The results from 2 cohorts, similar except for sex ratio, show that ERAS is a feasible and safe option for patients who undergo OAGB. Eighty-seven percent of the patients on ERAS met the goal of discharge on POD1. The simple changes, such as moving the hospital admission to the day of the operation, changing the target day of discharge to POD1, changing the anesthesia and analgesic protocols to short-acting agents and nonopioid painkillers, starting oral feeding early, and introducing nurse-led
Conclusion
The ERAS pathway significantly reduces the LOS of morbidly obese patients undergoing OAGB and reduces the number of 30-D ER visits. It also reduces the expenditure in 30-D follow-up without worsening surgical outcomes. Controlled randomized trials are needed to confirm these promising results.
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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