Anesthesia and Enhanced Recovery After Surgery in Bariatric Surgery

Riley, Christa L.

doi:10.1016/j.anclin.2021.11.006

Cited by 8 publications

(5 citation statements)

References 136 publications

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“…32,33 The applications of ERAS have gradually expanded from colorectal surgery to gastrointestinal surgery, obstetrics and gynaecology, orthopaedics, urology, cardiothoracic surgery and other disciplines. [34][35][36][37] The nurses, as professionals with close relationships with perioperative patients, play crucial roles in the ERAS pathway. 38 Several studies [39][40][41] have shown that the ERAS concept applied to LH can effectively reduce the incidence of postoperative complications, shorten the recovery time of the postoperative digestive tract and other body functions, reduce healthcare expenditures and lower 30-day postoperative readmission rates.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, several countries have published clinical guidelines and expert consensus on ERAS for surgery 32,33 . The applications of ERAS have gradually expanded from colorectal surgery to gastrointestinal surgery, obstetrics and gynaecology, orthopaedics, urology, cardiothoracic surgery and other disciplines 34–37 . The nurses, as professionals with close relationships with perioperative patients, play crucial roles in the ERAS pathway 38 …”

Section: Discussionmentioning

confidence: 99%

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Effects of enhance recovery after surgery nursing program on the surgical site wound infection in patients undergoing laparoscopic hepatectomy for hepatocellular carcinoma: A meta‐analysis

Liu,

Zhang,

Zhang

et al. 2023

International Wound Journal

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Our study aimed to investigate the effects of an enhanced recovery after surgery (ERAS) nursing program on surgical site wound infections (SSWI) and postoperative complications in patients undergoing laparoscopic hepatectomy (LH) for hepatocellular carcinoma. Computer searches of the PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure and Wanfang databases were conducted to gather randomised controlled trials (RCTs) that were published from inception to September 2023. The target studies evaluated the effects of the ERAS nursing program in patients undergoing LH for hepatocellular carcinoma. Two independent authors screened the literature, extracted the data and performed quality assessments. Dichotomous variables were analysed using odds ratios (ORs) and 95% confidence intervals (CIs), as effect analysis statistics. Stata software (version 17.0) was used for data analysis. Eleven RCTs with 765 patients were included, with 383 patients in the ERAS group and 382 in the control group. The results revealed that the incidence of SSWI (OR = 0.32, 95%CI:0.15–0.71, p = 0.004) and postoperative complications (OR = 0.23, 95%CI:0.15–0.34, p < 0.001) were both significantly reduced in the ERAS group, compared with the control group. The ERAS nursing program, when applied to patients undergoing laparoscopic hepatic cancer resection, can effectively reduce the incidence of SSWI and postoperative complications, thus promoting postoperative recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of enhance recovery after surgery nursing program on the surgical site wound infection in patients undergoing laparoscopic hepatectomy for hepatocellular carcinoma: A meta‐analysis

Liu,

Zhang,

Zhang

et al. 2023

International Wound Journal

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“…In this context, the laparoscopic approach offers many benefits, including reduced use of opioids, a shorter hospital stay, and faster postoperative recovery. However, the anaesthetic management of the obese patient is complex, since it requires an accurate assessment in order to estimate the risk of complications and consequently plan adequate postoperative treatment [3,4]. Even with often conflicting results, hospitalization in a postoperative intensive care unit (ICU) after bariatric surgery is mainly associated with risk factors such as advanced age; BMI greater than 50 kg/m 2 ; male gender; some specific comorbidities, such as OSAS and ischemic heart disease; duration of surgery; and intraoperative complications [5,6].…”

Section: Introductionmentioning

confidence: 99%

Obesity Surgery Mortality Risk Score as a Predictor for Intensive Care Unit Admission in Patients Undergoing Laparoscopic Bariatric Surgery

Aceto,

De Cicco,

Calabrese

et al. 2024

JCM

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Background: Laparoscopic bariatric surgery provides many benefits including lower postoperative pain scores, reduced opioid consumption, shorter hospital stays, and improved quality of recovery. However, the anaesthetic management of obese patients requires caution in determining postoperative risk and in planning adequate postoperative pathways. Currently, there are no specific indications for intensive care unit (ICU) admission in this surgical population and most decisions are made on a case-by-case basis. The aim of this study is to investigate whether Obesity Surgery Mortality Risk Score (OS-MRS) is able to predict ICU admission in patients undergoing laparoscopic bariatric surgery (LBS). Methods: We retrospectively reviewed data of patients who underwent LBS during a 2-year period (2017–2019). The collected data included demographics, comorbidities and surgery-related variables. Postoperative ICU admission was decided via bariatric anaesthesiologists’ evaluations, based on the high risk of postoperative cardiac or respiratory complications. Anaesthesia protocol was standardized. Logistic regression was used for statistical analysis. Results: ICU admission was required in 2% (n = 15) of the 763 patients. The intermediate risk group of the OS-MRS was detected in 84% of patients, while the American Society of Anaesthesiologists class III was reported in 80% of patients. A greater OS-MRS (p = 0.01), advanced age (p = 0.04), male gender (p = 0.001), longer duration of surgery (0.0001), increased number of patient comorbidities (p = 0.002), and previous abdominal surgeries (p = 0.003) were predictive factors for ICU admission. Conclusions: ICU admission in obese patients undergoing LBS is predicted by OS-MRS together with age, male gender, number of comorbidities, previous abdominal surgeries, and duration of surgery.

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“…A decade ago, most RYGB patients were hospitalized for 2 days [ 4 ]. However, with the widespread adoption of minimally invasive techniques and the application of Enhanced Recovery After Surgery (ERAS) protocols, the postoperative outcomes of RYGB have improved and the length of hospitalization has progressively decreased [ 5 – 8 ]. Several articles have demonstrated that RYGB patients can be discharged on postoperative day (POD) 1 without increasing the postoperative morbidity or readmission rates [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Recovery After Surgery (ERAS) protocols, the postoperative outcomes of RYGB have improved and the length of hospitalization has progressively decreased [5][6][7][8]. Several articles have demonstrated that RYGB patients can be discharged on postoperative day (POD) 1 without increasing the postoperative morbidity or readmission rates [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Is Same-Day Discharge After Roux-en-Y Gastric Bypass Safe? A Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Database Analysis

et al. 2022

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Purpose Same-day discharge (SDD) after bariatric surgery is gaining popularity. We aimed to analyze the safety of SDD after Roux-en-Y gastric bypass (RYGB) and compare its outcomes to inpatients discharged on postoperative days 1–2. Materials and Methods We performed a retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database for the period 2015–2020. Patients who underwent primary laparoscopic RYGB and were discharged the same day of the operation (SDD-RYGB) and inpatients discharged on postoperative days 1–2 (In-RYGB) were compared. Primary outcomes of interest were overall morbidity, serious morbidity, readmission, reoperation, intervention, and mortality rates. Results A total of 167,188 patients were included; 2156 (1.3%) SDD-RYGB and 165,032 (98.7%) In-RYGB. Mean age (SDD-RYGB: 44.5 vs. In-RYGB: 44.6 years), proportion of females (SDD-RYGB: 81.4% vs. In-RYGB: 80.6%), and mean body mass index (SDD-RYGB: 45.8 vs. In-RYGB: 45.9 kg/m 2 ) were similar between groups. Overall morbidity (SDD-RYGB: 11.3% vs. In-RYGB: 10.2%; OR: 1.2, p = 0.08), serious morbidity (SDD-RYGB: 3.1% vs. In-RYGB: 3%; OR: 1.03, p = 0.81), reoperation (SDD-RYGB: 1.4% vs. In-RYGB: 1.2%; OR: 1.16, p = 0.42), readmission (SDD-RYGB: 4.8% vs. In-RYGB: 4.8%; OR: 1.01, p = 0.89), and mortality (SDD-RYGB: 0.04% vs. In-RYGB: 0.09%; OR: 0.53, p = 0.53) were comparable between groups. SDD-RYGB had lower risk of 30-day interventions (SDD-RYGB: 1.1% vs. In-RYGB: 1.6%; OR: 0.64, p = 0.04) compared to In-RYGB. Conclusion Same-day discharge after RYGB seems to be safe and has comparable outcomes to admitted patients. Standardized patient selection criteria and perioperative management protocols are needed to further increase the safety of this practice. Graphical abstract

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Anesthesia and Enhanced Recovery After Surgery in Bariatric Surgery

Cited by 8 publications

References 136 publications

Effects of enhance recovery after surgery nursing program on the surgical site wound infection in patients undergoing laparoscopic hepatectomy for hepatocellular carcinoma: A meta‐analysis

Effects of enhance recovery after surgery nursing program on the surgical site wound infection in patients undergoing laparoscopic hepatectomy for hepatocellular carcinoma: A meta‐analysis

Obesity Surgery Mortality Risk Score as a Predictor for Intensive Care Unit Admission in Patients Undergoing Laparoscopic Bariatric Surgery

Is Same-Day Discharge After Roux-en-Y Gastric Bypass Safe? A Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Database Analysis

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