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The Application of Enhanced Recovery After Surgery (ERAS) for Patients Undergoing Bariatric Surgery: a Systematic Review and Meta-analysis

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Abstract

To systematically evaluate the effectiveness and safety of the enhanced recovery after surgery (ERAS) pathway in bariatric surgery. A literature search was conducted using PubMed, Medline, EMBASE, OVID, World Health Organization International Trial Register, and Cochrane Library identifying all eligible studies comparing ERAS protocols with standard care (SC) in bariatric surgery through May 2020. Relevant perioperative parameters were extracted from the resulting studies for meta-analysis. The primary outcome was the length of hospital stay, and secondary outcomes included operation time, postoperative nausea, and vomiting (PONV), postoperative complications, readmission, reoperation, and subsequent emergency room visits. Postoperative complications were categorized according to the Clavien–Dindo classification. Final analysis included five randomized controlled trials (RCTs) and twelve observational studies which included 4964 patients in the ERAS group and 3218 patients in the SC group. The length of the hospital stay was significantly decreased (p < 0.01) after ERAS protocol management, as did the incidence of POVN (p < 0.01). No significant differences were observed between the ERAS group and SC group in terms of operation time (p = 0.37), postoperative complications (p = 0.18), readmission (p = 0.17), reoperation (p = 0.34), or emergency room visits (p = 0.65). The application of ERAS protocols in bariatric surgery is safe and feasible, effectively shortening the length of a hospital stay without compromising morbidity, and accelerating patient recovery.

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Funding

This study was financially supported by National Natural Science Foundation of China (NO.81972269).

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Authors and Affiliations

  1. Graduate School, Dalian Medical University, West Section of Lvshun South Road No. 9, Dalian, 116044, China

    Jiajie Zhou, Rui Du, Feng Wang & Guifan Tong

  2. Department of General Surgery, Northern Jiangsu People’s Hospital, Nantong Road No. 98, Yangzhou, 225001, China

    Liuhua Wang, Wei Wang & Daorong Wang

  3. Graduate School, Medical College of Yangzhou University, Huaihai Road No. 7, Yangzhou, 225001, China

    Dongliang Li & Xu Ding

  4. Department of General Surgery, Northern Jiangsu People’s Hospital, Clinical Medical College, Yangzhou University, Institute of General Surgery-Yangzhou University, Nantong Road No. 98, Yangzhou, 225001, China

    Daorong Wang

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  1. Jiajie Zhou
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Correspondence to Daorong Wang.

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Zhou, J., Du, R., Wang, L. et al. The Application of Enhanced Recovery After Surgery (ERAS) for Patients Undergoing Bariatric Surgery: a Systematic Review and Meta-analysis. OBES SURG 31, 1321–1331 (2021). https://doi.org/10.1007/s11695-020-05209-5

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