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Does the Implementation of Enhanced Recovery After Surgery (ERAS) Guidelines Improve Outcomes of Bariatric Surgery? A Propensity Score Analysis in 464 Patients

  • Hugo Meunier
  • Yannick Le Roux
  • Anne-Lise Fiant
  • Yoann Marion
  • Adrien Lee Bion
  • Thomas Gautier
  • Nicolas Contival
  • Jean Lubrano
  • Fabienne Fobe
  • Marion Zamparini
  • Marie-Astrid Piquet
  • Véronique Savey
  • Arnaud Alves
  • Benjamin MenahemEmail author
Original Contributions
  • 56 Downloads

Abstract

Background

The aim of this study was to investigate whether the implementation of enhanced recovery after surgery (ERAS) guidelines according to Thorell and co. in our tertiary referral bariatric center might improve post-operative outcomes.

Methods

ERAS program was introduced in our center since January 1, 2017. Retrospective review of a prospectively collected database identified patients who underwent laparoscopic primary and revisional bariatric surgeries from October 2005 to January 2018. Patients exposed to ERAS program (“ERAS group”) were matched in a 1:1 ratio with patients exposed to conventional care (control group) using a propensity score based on age, gender, preoperative body mass index (BMI), diabetes mellitus, and the type of procedures. The primary outcome was total hospital length of stay (LOS) and the secondary outcomes included the post-operative complications and readmission rates.

Results

During the study period, 464 patients were included, 232 in each group. Implementation of the ERAS protocol was significantly associated with a reduction of LOS (2.47 ± 1.7 vs 5.39 ± 1.9 days, p < 0.00001). One-third of patients was discharged (77/232, 33%) on the first postoperative day (POD) and more than three quarter of patients on POD 2 (182/232, 77%). At the opposite, no patients of the control group were discharged on POD 2. Overall 30-day and 90-day morbidity and readmission rates were the same in both groups. There was no death in each group.

Conclusions

This large case-matched study using a propensity score analysis suggests that implementation of ERAS program significantly reduced length of hospital stay without significant increases on overall morbidity, and readmission rates.

Keywords

Laparoscopic bariatric surgery ERAS program Length of stay 

Notes

Compliance with Ethical Standards

This study has been approved by the local medical ethics committee; no individual inform consent was necessary as it was a retrospective analysis.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Hugo Meunier
    • 1
  • Yannick Le Roux
    • 1
  • Anne-Lise Fiant
    • 2
  • Yoann Marion
    • 1
  • Adrien Lee Bion
    • 1
  • Thomas Gautier
    • 3
  • Nicolas Contival
    • 4
  • Jean Lubrano
    • 1
    • 5
  • Fabienne Fobe
    • 2
  • Marion Zamparini
    • 2
  • Marie-Astrid Piquet
    • 6
  • Véronique Savey
    • 6
  • Arnaud Alves
    • 1
    • 5
  • Benjamin Menahem
    • 1
    • 5
    Email author
  1. 1.Department of Digestive SurgeryUniversity Hospital of CaenCaen cedexFrance
  2. 2.Department of AnesthesiaUniversity Hospital of CaenCaenFrance
  3. 3.Clinique Saint JeanMontpellierFrance
  4. 4.Groupe Hospitalier MutualisteGrenobleFrance
  5. 5.UNICAEN, INSERM, ANTICIPENormandie UnivCaenFrance
  6. 6.Department of NutritionUniversity Hospital of CaenCaenFrance

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