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Obesity Surgery
Published in: Obesity Surgery 3/2016

01-03-2016 | Original Contributions

Outcome of Laparoscopic Gastric Bypass (LRYGB) with a Program for Enhanced Recovery After Surgery (ERAS)

Authors: Tilda Hahl, Pipsa Peromaa-Haavisto, Pekka Tarkiainen, Otto Knutar, Mikael Victorzon

Published in: Obesity Surgery | Issue 3/2016

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Abstract

Background

Enhanced recovery after surgery (ERAS) programs are well established for patients undergoing colorectal surgery. Relatively little is known about ERAS following bariatric surgery in general or following laparoscopic Roux-en-Y gastric bypass (LRYGB) in particular.

Patients and Methods

This is a prospective, observational study of 388 consecutive patients that underwent LRYGB with ERAS in a general hospital. The ERAS protocol included standardizations of pre-, intra-, and postoperative modalities in order to reduce the stress response of the patients. Primary outcome measures were length of stay (LOS), postoperative morbidity, readmissions, and reoperations.

Results

Mean (SD) baseline body mass index (BMI) and age was 46.4 (6.7) kg/m2 and 45.1 (11.2) years, respectively. Fifty-four percent of the patients were on medication for hypertension (HT) and 38 % for type 2 diabetes mellitus (DM2). Mean (SD) and median (range) surgical time was 73.8 (16.9) and 65 (40–143) min, respectively. Mean LOS was 1.3 days (1.1), median 1 day (1–14). Of all patients, 322 (83 %) were discharged on the first postoperative day (POD). Overall morbidity was 9.8 %. Three patients (0.8 %) had life-threatening complications. The readmission rate was 4.9 %, and 3.4 % of the patients had to be reoperated. With a follow-up rate of 83 % at 1 year, total weight loss (TWL) was 31 % and excess BMI loss (EBMIL) 70 %. Total remission of DM2 and HT was achieved in 70 and 42 % of the patients, respectively.

Conclusion

Enhanced recovery following LRYGB with ERAS programs is possible and safe even in a low volume, general hospital. Early discharge does not increase postoperative morbidity or readmissions.
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Metadata
Title
Outcome of Laparoscopic Gastric Bypass (LRYGB) with a Program for Enhanced Recovery After Surgery (ERAS)
Authors
Tilda Hahl
Pipsa Peromaa-Haavisto
Pekka Tarkiainen
Otto Knutar
Mikael Victorzon
Publication date
01-03-2016
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1799-z

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