Outcome of Laparoscopic Gastric Bypass (LRYGB) with a Program for Enhanced Recovery After Surgery (ERAS)

Hahl, Tilda; Peromaa-Haavisto, Pipsa; Tarkiainen, Pekka; Knutar, Otto; Victorzon, Mikael

doi:10.1007/s11695-015-1799-z

Cited by 43 publications

(34 citation statements)

References 33 publications

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“…As we all know, Enhanced Recovery After Surgery (ERAS) has been developed for different types of abdominal surgeries in search of efficient and cost‐effective health care . ERAS can also be implemented for bariatric surgery with reduced hospital stay . With ERAS adopted extensively, there will have standardized criteria of hospital discharge to compare the results of different studies.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of laparoscopic sleeve gastrectomy versus laparoscopic Roux‐en‐Y gastric bypass: A systematic review and meta‐analysis

Zhao

Liu

Wang

et al. 2019

Evaluation Clinical Practice

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Background: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are widely performed to cure obesity and obesity-related diseases. Our aim was to compare these two procedures. Materials and methods:An electronic literature search was performed from inception to December 2018. The clinical outcomes between LSG and LRYGB were pooled using software RevMan5.3. Results: A total of 1076 patients from 11 studies were analysed. LSG had shorter operation time (mean difference [MD] = −33.81; 95% confidence interval [CI], −46.04 to −21.57; P < .00001) and less early complications rate (risk ratio [RR] = 0.55;95% CI, 0.36-0.84; P = .005) compared with LRYGB. There were no significant difference about the readmission rate (RR = 0.57; 95% CI, 0.21-1.54; P = .27) and reoperation rate (RR = 0.43; 95% CI, 0.14-1.27; P = .13) between LSG and LRYGB.The conversion to open rate and mortality rate within 30 days was low in both LSG and LRYGB. Mean hospital stay in LSG group (0.3-5.2 d) seems shorter than that in the LRYGB group (2.3-6.6 d). As to the effect of LSG and LRYGB on the percentage of excess weight loss (EWL), there was no significant difference between these two surgeries in EWL (MD = −4.05; 95% CI, −8.89 to 0.80; P = .10). LSG was equal to LRYGB on remission of T2DM (RR = 0.94; 95% CI, 0.84-1.06; P = .31). Conclusions: Both LSG and LRYGB can be performed with very low conversion toopen rate and mortality rate. The readmission rate and re-operation rate are comparable between these two surgeries. The efficacy of these two surgeries on EWL and T2DM is equivalent, but LSG has an advantage over LRYGB in operation time and early complications rate.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of laparoscopic sleeve gastrectomy versus laparoscopic Roux‐en‐Y gastric bypass: A systematic review and meta‐analysis

Zhao

Liu

Wang

et al. 2019

Evaluation Clinical Practice

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“…Perioperative care according to the principles of ERAS protocol, which is also applied in our center, was proved to be feasible, effective, and enabling early discharge in bariatric surgery [ 14 , 29 , 30 ]. Barreca and colleagues published an article stating that implementation of ERAS protocol among bariatric patients led to > 40% of patients being discharged within 24 h from the operation [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Care and Functional Recovery After Laparoscopic Sleeve Gastrectomy vs. Laparoscopic Roux-en-Y Gastric Bypass Among Patients Under ERAS Protocol

Major

Stefura²,

Małczak

et al. 2017

OBES SURG

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BackgroundThe most commonly performed bariatric procedures are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). There are major differences between LSG and LRYGB during postoperative period. Optimization of the postoperative care may be achieved by using enhanced recovery after surgery (ERAS) protocol, which allows earlier functional recovery.PurposeThe aim was to assess differences in the course of postoperative care conducted in accordance with ERAS protocol among patients after LSG and LRYGB.Material and MethodsData concerning patients treated for morbid obesity were prospectively gathered in one academic center. Patients were divided into two groups: LSG (n = 364, 63.41%) and LRYGB (n = 210, 36.59%). Multiple factors were used as endpoints to determine the influence of the type of bariatric procedure on postoperative course.ResultsThe rate of postoperative nausea and vomiting and incidence of intravenous fluid administration during the operation was higher in LSG group. LRYGB patients were able to tolerate higher oral fluid intake volumes during the first and the second postoperative day. Mean diuresis during the second and the third postoperative day was significantly higher in LRYGB group. Administration of diuretics and painkillers was comparable between groups, while the risk of fever after the operation was higher in LRYGB group. Mean length of stay was higher in LSG group (LRYGB vs. LSG, 3.46 days ± 1.58 vs. 3.64 days ± 4.41, p = 0.039).ConclusionsIn our opinion, postoperative treatment after LSG requires more supervision and longer time until functional recovery is achieved.

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“…Lemanu et al (10) in a randomized clinical trial proved that most of the patients can be discharged from the hospital safely in the first postoperative day. Similar studies are available for laparoscopic Roux-en-Y gastric bypass (11). Furthermore, thanks to the ERAS protocol, the cost of treatment can be cut down, proving cost-effectiveness of ERAS strategy (12).…”

Section: Enhanced Recovery After Surgery (Eras)mentioning

confidence: 85%

Innovative solutions in bariatric surgery

et al. 2016

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Outcome of Laparoscopic Gastric Bypass (LRYGB) with a Program for Enhanced Recovery After Surgery (ERAS)

Abstract: Enhanced recovery following LRYGB with ERAS programs is possible and safe even in a low volume, general hospital. Early discharge does not increase postoperative morbidity or readmissions.

Cited by 43 publications

References 33 publications

Safety and efficacy of laparoscopic sleeve gastrectomy versus laparoscopic Roux‐en‐Y gastric bypass: A systematic review and meta‐analysis

Safety and efficacy of laparoscopic sleeve gastrectomy versus laparoscopic Roux‐en‐Y gastric bypass: A systematic review and meta‐analysis

Postoperative Care and Functional Recovery After Laparoscopic Sleeve Gastrectomy vs. Laparoscopic Roux-en-Y Gastric Bypass Among Patients Under ERAS Protocol

Innovative solutions in bariatric surgery

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