The effectiveness of bariatric surgery has been well-studied. However, complications after bariatric surgery have been understudied. This review assesses <30-d major complications associated with bariatric procedures, including anastomotic leak, myocardial infarction and pulmonary embolism. This review included 71 studies conducted in the USA between 2003 and 2014 and 107,874 patients undergoing either gastric bypass, adjustable gastric banding or sleeve gastrectomy, with mean age of 44 years and pre-surgery body mass index of 46.5 kg m . Less than 30-d anastomotic leak rate was 1.15%; myocardial infarction rate was 0.37%; pulmonary embolism rate was 1.17%. Among all patients, mortality rate following anastomotic leak, myocardial infarction and pulmonary embolism was 0.12%, 0.37% and 0.18%, respectively. Among surgical procedures, <30-d after surgery, sleeve gastrectomy (1.21% [95% confidence interval, 0.23-2.19%]) had higher anastomotic leak rate than gastric bypass (1.14% [95% confidence interval, 0.84-1.43%]); gastric bypass had higher rates of myocardial infarction and pulmonary embolism than adjustable gastric banding or sleeve gastrectomy. During the review, we found that the quality of complication reporting is lower than the reporting of other outcomes. In summary, <30-d rates of the three major complications after either one of the procedures range from 0% to 1.55%. Mortality following these complications ranges from 0% to 0.64%. Future studies reporting complications after bariatric surgery should improve their reporting quality.

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The enhanced recovery after thoracic surgery (ERATS) protocol has been shown to reduce complications and hospital length of stay (LOS). [1][2][3] In thoracic surgery, the prototypical ERATS pathway involves a preoperative phase, which focuses on patient education and smoking cessation; the intraoperative phase incorporates multimodal anesthesia along with minimally invasive surgery (video-assisted thoracoscopic surgery [VATS]); and the postoperative phase emphasizes the use of incentive spirometry, early mobilization, early chest tube and urinary catheter removal. Goal-directed fluid therapy and minimization of opioids is encouraged. [2][3][4] Most of the evidence for ERATS has been published in small, retrospective, single-center studies and case-series reports, all of which are prone to bias. [5][6][7] In 2016, Fiore and colleagues 8 published a systematic review (SR) of 6 studies on ERATS in lung resections; however, the authors determined their results were inconclusive due to high risk of bias. Li and colleagues 9 also published a SR of 7 randomized-controlled trials (RCTs), but all study participants were from China, Europe, and the Middle East. In 2019, Batchelor and colleagues 3 formulated ERATS guidelines for the Enhanced Recovery After Surgery (ERAS) Society and the European Society of Thoracic Surgeons with an SR. Recently, a few retrospective cohort studies of ERATS in lung resections have been conducted in the United States and Canada, demonstrating that ERATS improves patient outcomes after lung resections and provides more cost-effective care. [10][11][12] In this updated SR and metaanalysis, we aimed to synthesize the evidence regarding the effect of ERATS, in comparison to conventional care, on surgical outcomes of adult patients undergoing lung resections. We hypothesized that ERATS would improve surgical outcomes by decreasing hospital LOS, postoperative complications, and readmission rates. METHODS Eligibility CriteriaThis SR was conducted in compliance with the preferred reporting items for systematic reviews and meta-analyses statement. 13 We developed inclusion and exclusion criteria with respect to populations, interventions, comparators, outcomes, timing, setting, and study designs (Table E1). Studies

Summary To better understand outcomes in postpartum patients who receive peripartum anaesthetic interventions, we aimed to assess quality of recovery metrics following childbirth in a UK‐based multicentre cohort study. This study was performed during a 2‐week period in October 2021 to assess in‐ and outpatient post‐delivery recovery at 1 and 30 days postpartum. The following outcomes were reported: obstetric quality of recovery 10‐item measure (ObsQoR‐10); EuroQoL (EQ‐5D‐5L) survey; global health visual analogue scale; postpartum pain scores at rest and movement; length of hospital stay; readmission rates; and self‐reported complications. In total, 1638 patients were recruited and responses analysed from 1631 (99.6%) and 1282 patients (80%) at one and 30 days postpartum, respectively. Median (IQR [range]) length of stay postpartum was 39.3 (28.5–61.0 [17.7–513.4]), 40.3 (28.5–59.1 [17.8–220.9]), and 35.9 (27.1–54.1 [17.9–188.4]) h following caesarean, instrumental and vaginal deliveries, respectively. Median (IQR [range]) ObsQoR‐10 score was 75 ([62–86] 4–100) on day 1, with the lowest ObsQoR‐10 scores (worst recovery) reported by patients undergoing caesarean delivery. Of the 1282 patients, complications within the first 30 days postpartum were reported by 252 (19.7%) of all patients. Readmission to hospital within 30 days of discharge occurred in 69 patients (5.4%), with 49 (3%) for maternal reasons. These data can be used to inform patients regarding expected recovery trajectories; facilitate optimal discharge planning; and identify populations that may benefit most from targeted interventions to improve postpartum recovery experience.