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Enhanced Recovery After Surgery Protocol in Bariatric Surgery Leads to Decreased Complications and Shorter Length of Stay

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Abstract

Purpose

Enhanced recovery after surgery (ERAS) programs have been shown in some specialties to improve short-term outcomes following surgical procedures. There is no consensus regarding the optimal perioperative care for bariatric surgical patients. The purpose of this study was to develop a bariatric ERAS protocol and determine whether it improved outcomes following surgery.

Materials and Methods

An IRB-approved prospectively maintained database was retrospectively reviewed for all patients undergoing bariatric surgery from October 2018 to January 2020. Propensity matching was used to compare post-ERAS implementation patients to pre-ERAS implementation.

Results

There were 319 patients (87 ERAS, 232 pre-ERAS) who underwent bariatric operations between October 2018 and January 2020. Seventy-nine patients were kept on the ERAS protocol whereas 8 deviated. Patients who deviated from the ERAS protocol had a longer length of stay when compared to patients who completed the protocol. The use of any ERAS protocol (completed or deviated) reduced the odds of complications by 54% and decreased length of stay by 15%. Furthermore, patients who completed the ERAS protocol had an 83% reduction in odds of complications and 31% decrease in length of stay. Similar trends were observed in the matched cohort with 74% reduction in odds of complications and 26% reduction in length of stay when ERAS was used.

Conclusions

ERAS protocol decreases complications and reduces length of stay in bariatric patients.

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Authors and Affiliations

  1. Department of Minimally Invasive Surgery, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX, 75246, USA

    Lucas C. Fair, Steven G. Leeds, Madeline L. Rasmussen, Daniel G. Davis, David T. Arnold & Marc A. Ward

  2. Center for Advanced Surgery, Baylor Scott and White Health, 3417 Gaston Ave Suite 965, Dallas, TX, 75246, USA

    Lucas C. Fair, Steven G. Leeds, Madeline L. Rasmussen & Marc A. Ward

  3. Research Institute, Baylor Scott and White Health, 3535 Worth St., Suite C3.510, Dallas, TX, 75246, USA

    Lucas C. Fair, Syed Harris Bokhari & Gerald O. Ogola

  4. Texas A&M College of Medicine, Bryan, TX, 77807, USA

    Steven G. Leeds, Edward P. Whitfield, Salman S. Hasan, Daniel G. Davis, David T. Arnold & Marc A. Ward

  5. Center for Medical and Surgical Weight Loss Management, Baylor University Medical Center, Dallas, TX, 75246, USA

    Daniel G. Davis

Authors
  1. Lucas C. Fair
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  2. Steven G. Leeds
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  6. Salman S. Hasan
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  7. Daniel G. Davis
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  8. David T. Arnold
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  9. Gerald O. Ogola
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  10. Marc A. Ward
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Contributions

All authors listed above contributed to this manuscript and meet the requirements of appropriate authorship as defined by the International Committee of Medical Journal Editors (ICMJE).

Corresponding author

Correspondence to Marc A. Ward.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Informed consent does not apply.

Conflict of Interest

The authors declare no competing interests.

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Key Points

• ERAS protocols in bariatric surgery reduce complications and length of stay.

• This reduction is further pronounced when the protocol is completed.

• Reduced complications and length of stay were also found in matched cohorts.

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Fair, L.C., Leeds, S.G., Whitfield, E.P. et al. Enhanced Recovery After Surgery Protocol in Bariatric Surgery Leads to Decreased Complications and Shorter Length of Stay. OBES SURG 33, 743–749 (2023). https://doi.org/10.1007/s11695-023-06474-w

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  • DOI: https://doi.org/10.1007/s11695-023-06474-w

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