Conventional versus fast track anaesthesia in an unselected group of patients undergoing revisional bariatric surgery

Abstract

Introduction:Fast track care has proven to be safe and effective in primary bariatric procedures. The number of more complex revisional procedures is expected to rise over the next years. The aim was to evaluate the potential benefits and safety of a fast-track protocol in an unselected group of patients undergoing Roux-en-Y Gastric Bypass (rRYGBP) as revision. Method: For this retrospective study, all patients undergoing rRYGBP between January 2005 and December 2013 were included and categorized between conventional care (CC) and fast track care (FT). Patient characteristics, operative details and intra-and early postoperative complications < 30 days were analysed. Results: A total of 407 patients were included for analysis. 303 patients (74.4%) received peri-and postoperative treatment according to the fast track protocol. Mean age of the study population was 44.0 ± 8.9 years; mean pre-primary procedure BMI was 45.7 ± 7.0 kg/m 2 . A total of 54 (13.3%) postoperative complications were registered (CC 19.2% vs FT 11.2%; p = 0.038). Both operative time (CC 135.3 ± 42.6 minutes vs FT 79.3 ± 29.3 minutes; p < 0.001) as well as hospital stay (CC 5.1 ± 6.3 days vs FT 3.1 ± 5.3 days; p < 0.001) were significantly shorter in the FT group. A multivariate analysis on postoperative complications showed that fast track was not predictive for the occurrence of complications (OR = 0.853; 95% CI [0.403-1.804]; p = 0.677). Conclusion:Fast track care appears to be safe and efficient for patients undergoing revisional Rouxen-Y gastric bypass, but postoperative outcome may be highly dependent on surgical experience.

The RAQET Study: the Effect of Eating a Popsicle Directly After Bariatric Surgery on the Quality of Patient Recovery; a Randomised Controlled Trial

“…These programs improve efficiency and reduce postoperative complications, especially after bariatric surgery. Our research group and also others showed that a fast-track approach in the bariatric patient population is safe and efficient [1][2][3][4][5].…”

Implementation of perioperative anesthetic management in morbide obese patiens undergoing laparascopic bariatric surgeryaccording to enhanced recovery program

“…Ó 2016 ðîö³ áóëè îïóáë³êîâàí³ ðåêîìåíäàö³¿ ùîäî ³ìïëåìåí-òàö³¿ êîìïîíåíò³â ERAS â áàð³àòðè÷íó õ³ðóðã³þ [9]. Ïðîòîêîë ïðèñêîðåíîãî âåäåííÿ ï³ñëÿ áà-ð³àòðè÷íèõ âòðó÷àíü (ERABS) áóâ ³ìïëåìåíòîâàíèé â áàãàòüîõ Çàõ³äíîºâðîïåéñüêèõ áàð³àò-ðè÷íèõ öåíòðàõ [5][6][7][8] òà âêëþ÷ຠâ ñåáå êðàùó ïðàêòèêó ïåðåäîïåðàö³éíî¿ ï³äãîòîâêè òà ñòàí-äàðòèçàö³¿ ïåð³îïåðàö³éíî¿ òà ï³ñëÿîïåðàö³éíî¿ äîïîìîãè, ÿêà çàáåçïå÷èòü øâèäêå îäóaeàííÿ ³ ïîë³ïøèòü ðåçóëüòàò ë³êóâàííÿ. Àëå çàëèøàºòüñÿ íåÿñíèì, ÷è âñ³ êîìïîíåíòè êëàñè÷íîãî ïðîòîêîëó (ìàë.…”

Applying Enhanced Recovery After Bariatric Surgery (ERABS) Protocol for Morbidly Obese Patients With End-Stage Renal Failure

“…Enhanced Recovery After Bariatric Surgery (ERABS) has been implemented in many bariatric centers to optimize the patient pathway care and its safety and efficacy are well known [12][13][14][15]. The ERABS protocol is associated with improved quality of the surgical treatment.…”

“…The ERABS protocol is associated with improved quality of the surgical treatment. This includes a best practice of preoperative preparation and standardization of perioperative and postoperative care, which would ensure early recovery and improves the outcome [12][13][14][15]. In 2015, the ERABS protocol was implemented and also morbidly obese patients with ESRD were enrolled in it.…”