Complications in Patients Undergoing Laparoscopic Bariatric Surgery in an ERABS-optimized, High-Volume, Single Center During 2020 and 2021

Katrine Stryhn, Lærke Alstrup, Claus Riber, Michael Ørting, Rakin Hadad, Jan Hvistendahl, Carsten Tollund, Niels Boye, Steen B Haugaard, Peter Funch-Jensen

Abstract

PURPOSE: Complication rates after fast-track optimization in bariatric surgery are varying. The aim of this study was to identify short-term complications in patients undergoing laparoscopic sleeve gastrectomy (SG) in an ERABS (enhanced recovery after bariatric surgery) optimized setup.

MATERIALS AND METHODS: This study is an observational analysis of a consecutive cohort of 1600 patients undergoing SG at an ERABS-optimized, private hospital during 2020 and 2021. Primary outcomes were length of stay, mortality, readmissions, reoperations, and complications according to the Clavien-Dindo classification (CDC) within postoperative day (POD) 30 and 90. Secondary outcomes were weight loss and quality of life (QoL) according to Moorehead-Ardelt questionnaires during the first postoperative year.

RESULTS: Primary outcomes: 99.1% of patients were discharged within POD 1. The 90-day mortality rate was zero. There were 1% readmissions and 1.2% reoperations within POD 30. Total 30-day complication rate was 4.6%, where 3.4% accounted for CDC grades ≤ II, and 1.3% accounted for CDC grade III. There were zero grade IV-V complications.

SECONDARY OUTCOMES: One year after surgery, weight loss was substantial (p < 0.001), with an excess weight loss of 71.9%, and QoL had significantly increased (p < 0.001).

CONCLUSION: This study demonstrates that the use of an ERABS protocol in bariatric surgery does not compromise neither safety nor efficacy. Complication rates were low, and weight loss was significant. This study thus provides strong arguments that ERABS programs are beneficial in bariatric surgery.

Original languageEnglish
JournalObesity Surgery
Volume33
Issue number7
Pages (from-to)2064-2071
Number of pages8
ISSN0960-8923
DOIs
Publication statusPublished - Jul 2023

Keywords

  • Humans
  • Quality of Life
  • Obesity, Morbid/surgery
  • Laparoscopy/methods
  • Enhanced Recovery After Surgery
  • Length of Stay
  • Postoperative Complications/etiology
  • Bariatric Surgery/methods
  • Gastrectomy/adverse effects
  • Weight Loss
  • Retrospective Studies

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