Skip to main content
Top
Published in: Obesity Surgery 11/2020

Open Access 01-11-2020 | Sleeve Gastrectomy | Brief Communication

Connected Surveillance for Detection of Complications After Early Discharge from Bariatric Surgery

Authors: Maud Neuberg, Marie-Cécile Blanchet, Benoit Gignoux, Vincent Frering

Published in: Obesity Surgery | Issue 11/2020

Login to get access

Abstract

As part of a bariatric enhanced recovery after surgery (ERAS) program, at-home follow-up using a novel Internet application was used to detect early complications. The study aimed to evaluate the safety and effectiveness of this “connected surveillance” protocol over a 10-day follow-up. Patients were monitored 24/7 by a trained nursing team with daily surgeon review of patient self-reports. Morbidly obese patients (n = 281) underwent OAGB (126, 47.70%) or sleeve gastrectomy (138, 52.3%). Of 264 who completed the study (mean age 40 years [20–66]), 3 (1.1%) underwent revision for early complications; there were 6 (2.1%) readmissions and 22 (8.3%) consultations. In a bariatric surgery ERAS program, “Internet-connected surveillance” proved safe and effective in detecting 100% of early complications, and most patients were satisfied with their care.
Literature
1.
go back to reference Thorell A, MacCormick AD, Awad S, et al. Guidelines for perioperative care in bariatric surgery: enhanced recovery after surgery (ERAS) society recommendations. World J Surg. 2016;40:2065–83.CrossRef Thorell A, MacCormick AD, Awad S, et al. Guidelines for perioperative care in bariatric surgery: enhanced recovery after surgery (ERAS) society recommendations. World J Surg. 2016;40:2065–83.CrossRef
2.
go back to reference Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS) society recommendations: 2018. World J Surg. 2019;43:659–95.CrossRef Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS) society recommendations: 2018. World J Surg. 2019;43:659–95.CrossRef
3.
go back to reference Hu ZC, He LJ, Chen D, et al. An enhanced recovery after surgery program in orthopedic surgery: a systematic review and meta-analysis. J Orthop Surg Res. 2019;14:77.CrossRef Hu ZC, He LJ, Chen D, et al. An enhanced recovery after surgery program in orthopedic surgery: a systematic review and meta-analysis. J Orthop Surg Res. 2019;14:77.CrossRef
4.
go back to reference Ahmed OS, Rogers AC, Bolger JC, et al. Meta-analysis of enhanced recovery protocols in bariatric surgery. J Gastrointest Surg. 2018;22:964–72.CrossRef Ahmed OS, Rogers AC, Bolger JC, et al. Meta-analysis of enhanced recovery protocols in bariatric surgery. J Gastrointest Surg. 2018;22:964–72.CrossRef
5.
go back to reference Barrecca M, Renzi C, Tankel J, et al. Is there a role for enhanced recovery after laparoscopic bariatric surgery? Preliminary results from a specialist obesity treatment center. Surg Obes Relat Dis. 2016 Jan;12(1):119–26.CrossRef Barrecca M, Renzi C, Tankel J, et al. Is there a role for enhanced recovery after laparoscopic bariatric surgery? Preliminary results from a specialist obesity treatment center. Surg Obes Relat Dis. 2016 Jan;12(1):119–26.CrossRef
6.
go back to reference Sowers MD, Lemanu DP, Hill AG. Health economics in enhanced recovery after surgery programs. Can J Anaesth. 2015;62:219–30.CrossRef Sowers MD, Lemanu DP, Hill AG. Health economics in enhanced recovery after surgery programs. Can J Anaesth. 2015;62:219–30.CrossRef
7.
go back to reference Rickey J, Gersin K, Yang W, et al. Early discharge in the bariatric population does not increase post-discharge resource utilization. Surg Endosc. 2017 Feb;31(2):618–24.CrossRef Rickey J, Gersin K, Yang W, et al. Early discharge in the bariatric population does not increase post-discharge resource utilization. Surg Endosc. 2017 Feb;31(2):618–24.CrossRef
8.
go back to reference Chang SH, Freeman NLB, Lee JA, et al. Early major complications after bariatric surgery in the USA, 2003-2014: a systematic review and meta-analysis. Obes Rev. 2018 April;19(4):529–37.CrossRef Chang SH, Freeman NLB, Lee JA, et al. Early major complications after bariatric surgery in the USA, 2003-2014: a systematic review and meta-analysis. Obes Rev. 2018 April;19(4):529–37.CrossRef
9.
go back to reference Johanet H, Vons C, Beaussier M. Chirurgie Ambulatoire Generale et Digestive Monographie de l’association française de chirurgie: présenté au 119e Congrès français de chirurgie, Paris, 27–29 septembre 2017. Monographies de l'Association française de chirurgie. Montrouge; Arnette, 2017. Johanet H, Vons C, Beaussier M. Chirurgie Ambulatoire Generale et Digestive Monographie de l’association française de chirurgie: présenté au 119e Congrès français de chirurgie, Paris, 27–29 septembre 2017. Monographies de l'Association française de chirurgie. Montrouge; Arnette, 2017.
10.
go back to reference NIH Consensus Development Conference Statement: gastrointestinal surgery for severe obesity. Obes Surg. 1991;1:243–56. NIH Consensus Development Conference Statement: gastrointestinal surgery for severe obesity. Obes Surg. 1991;1:243–56.
11.
go back to reference Fried M, Hainer V, Basdevant A, et al. Interdisciplinary European guidelines on surgery of severe obesity. Int J Obes. 2007;31(4):569–77.CrossRef Fried M, Hainer V, Basdevant A, et al. Interdisciplinary European guidelines on surgery of severe obesity. Int J Obes. 2007;31(4):569–77.CrossRef
12.
go back to reference Blanchet M-C, Gignoux B, Matussiere Y, et al. Experience with an enhanced recovery after surgery (ERAS) program for bariatric surgery: comparison of MGB and LSG in 374 patients. Obes Surg. 2017;27(7):1896–900.CrossRef Blanchet M-C, Gignoux B, Matussiere Y, et al. Experience with an enhanced recovery after surgery (ERAS) program for bariatric surgery: comparison of MGB and LSG in 374 patients. Obes Surg. 2017;27(7):1896–900.CrossRef
13.
go back to reference Kahokehr A, Sammour T, Srinivasa S, et al. Systematic review and meta-analysis of intraperitoneal local anaesthetic for pain reduction after laparoscopic gastric procedures. Br J Surg. 2011;98(1):29–36.CrossRef Kahokehr A, Sammour T, Srinivasa S, et al. Systematic review and meta-analysis of intraperitoneal local anaesthetic for pain reduction after laparoscopic gastric procedures. Br J Surg. 2011;98(1):29–36.CrossRef
14.
go back to reference Obi AT, Pannucci CJ, Nackashi A, et al. Validation of the Caprini venous thromboembolism risk assessment model in critically ill surgical patients. JAMA Surg. 2015;150(10):941–8.CrossRef Obi AT, Pannucci CJ, Nackashi A, et al. Validation of the Caprini venous thromboembolism risk assessment model in critically ill surgical patients. JAMA Surg. 2015;150(10):941–8.CrossRef
15.
go back to reference Blanchet M-C, Frering V, Gignoux B, et al. Four-year evolution of a thrombophylaxis protocol in an enhanced recovery after surgery (ERAS) program: recent results in 485 patients. Obes Surg. 2018;28:2140–4.CrossRef Blanchet M-C, Frering V, Gignoux B, et al. Four-year evolution of a thrombophylaxis protocol in an enhanced recovery after surgery (ERAS) program: recent results in 485 patients. Obes Surg. 2018;28:2140–4.CrossRef
16.
go back to reference Lazzati A, Guy-Lachuer R, Delaunay V, et al. Bariatric surgery trends in France: 2005-2011. Surg Obes Relat Dis. 2014;10(2):328–34.CrossRef Lazzati A, Guy-Lachuer R, Delaunay V, et al. Bariatric surgery trends in France: 2005-2011. Surg Obes Relat Dis. 2014;10(2):328–34.CrossRef
17.
go back to reference Lazzati A, Audureau E, Hemery F, et al. Reduction in early mortality outcomes after bariatric surgery in France between 2007 and 2012: a nationwide study of 133,000 obese patients. Surgery. 2016;159(2):467–74.CrossRef Lazzati A, Audureau E, Hemery F, et al. Reduction in early mortality outcomes after bariatric surgery in France between 2007 and 2012: a nationwide study of 133,000 obese patients. Surgery. 2016;159(2):467–74.CrossRef
18.
go back to reference Ferreira LE, Chanson LM, Baron TH. Gestion de l'hémorragie postopératoire aiguë chez le patient obèse. Gastrointest Endosc Clin N Am. 2011;21(2):287–94.CrossRef Ferreira LE, Chanson LM, Baron TH. Gestion de l'hémorragie postopératoire aiguë chez le patient obèse. Gastrointest Endosc Clin N Am. 2011;21(2):287–94.CrossRef
19.
go back to reference Nguyen NT, Paya M, Stevens CM, et al. The relationship between hospital volume and out- come in bariatric surgery at academic medical centers. Ann Surg. 2004;240:586–93. discussion 593–94PubMedPubMedCentral Nguyen NT, Paya M, Stevens CM, et al. The relationship between hospital volume and out- come in bariatric surgery at academic medical centers. Ann Surg. 2004;240:586–93. discussion 593–94PubMedPubMedCentral
20.
go back to reference Saunders J, Ballantyne GH, Belsley S, et al. One-year read- mission rates at a high volume bariatric surgery center: laparo- scopic adjustable gastric banding, laparoscopic gastric bypass, and vertical banded gastroplasty-Roux-en-Y gastric bypass. Obes Surg. 2008;18(10):1233–40.CrossRef Saunders J, Ballantyne GH, Belsley S, et al. One-year read- mission rates at a high volume bariatric surgery center: laparo- scopic adjustable gastric banding, laparoscopic gastric bypass, and vertical banded gastroplasty-Roux-en-Y gastric bypass. Obes Surg. 2008;18(10):1233–40.CrossRef
21.
go back to reference Muñoz JL, Ruiz-Tovar J, Miranda E, et al. C-reactive protein and procalcitonin as early markers of septic complications after laparoscopic sleeve gastrectomy in morbidly obese patients within an enhanced recovery after surgery program. J Am Coll Surg. 2016;222(5):831–7.CrossRef Muñoz JL, Ruiz-Tovar J, Miranda E, et al. C-reactive protein and procalcitonin as early markers of septic complications after laparoscopic sleeve gastrectomy in morbidly obese patients within an enhanced recovery after surgery program. J Am Coll Surg. 2016;222(5):831–7.CrossRef
22.
go back to reference Brethauer SA, Grieco A, Fraker T, et al. Employing enhanced recovery goals in bariatric surgery (ENERGY): a national quality improvement project using the metabolic and bariatric surgery accreditation and quality improvement program. Surg Obes Relat Dis. 2019;15(11):1977–89.CrossRef Brethauer SA, Grieco A, Fraker T, et al. Employing enhanced recovery goals in bariatric surgery (ENERGY): a national quality improvement project using the metabolic and bariatric surgery accreditation and quality improvement program. Surg Obes Relat Dis. 2019;15(11):1977–89.CrossRef
Metadata
Title
Connected Surveillance for Detection of Complications After Early Discharge from Bariatric Surgery
Authors
Maud Neuberg
Marie-Cécile Blanchet
Benoit Gignoux
Vincent Frering
Publication date
01-11-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 11/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04817-5

Other articles of this Issue 11/2020

Obesity Surgery 11/2020 Go to the issue