Enhanced recovery after surgery (ERAS) in one-anastomosis gastric bypass surgery: a matched-cohort study

Abstract

Background: One-anastomosis gastric bypass (OAGB) is considered new from the bariatric standpoint. Objectives: To assess the effectiveness and safety of the enhanced recovery after surgery protocol compared with the conventional approach in perioperative care of OAGB patients. Setting: Turkey. Methods: The prospectively collected data of 92 patients managed with standard care (group 1) were compared with 216 patients managed by the enhanced recovery after surgery pathway (group 2). All patients underwent OAGB by the same surgeon. The groups were compared in terms of mean postoperative length of stay; costs for surgery and recovery; and rates of complications, emergency room visits, and readmissions. Results: Length of stay was always 5 days in group 1 and had a mean of 1.2 +/- 1.3 days in group 2 (P<.001). The mean total cost for surgery and recovery was 858.6 +/- 33.1 USD in group 1 and 625.2 +/- 289.1 USD in group 2 (P<.001). Specific complications (Clavien-Dindo IIIa) occurred in 1 patient (1.1%) in group 1 and in 3 patients (1.4 %) in group 2 (P=1.000). Fifty-seven patients (61.9%) in group 1 and 45 (20.9%) in group 2 visited the emergency room within 1 month of being discharged (P<.001). Two patients (.9%) in group 2 needed hospital readmission; there was no need for rehospitalization in group 1 (P<.001). Conclusion: The enhanced recovery after surgery pathway significantly reduces length of stay and cost after OAGB, with no significant difference in terms of surgical outcomes. It also reduces postdischarge resource utilization. (C) 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.