Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

World Journal of Surgery - Tập 40 Số 9 - Trang 2065-2083 - 2016
Anders Thorell1, Andrew D. MacCormick2,3, Sherif Awad4,5, Nick Reynolds5, Didier Roulin6, Nicolas Demartines6, Marie Vignaud7, Adrián Alvarez8, Preet Mohinder Singh9, Dileep N. Lobo10
1Karolinska Institutet, Department of Clinical Sciences, Danderyds Hospital & Department of Surgery, Ersta Hospital, 116 91, Stockholm, Sweden
2Department of Surgery, Counties Manukau Health, Auckland, New Zealand
3Department of Surgery, University of Auckland, Auckland, New Zealand
4School of Clinical Sciences University of Nottingham NG7 2UH Nottingham UK
5The East-Midlands Bariatric & Metabolic Institute, Derby Teaching Hospitals NHS Foundation Trust, Royal Derby Hospital, Derby, DE22 3NE, UK
6Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland
7Département d’anesthésie reanimation Service de chirurgie digestive CHU estaing 1 place Lucie et Raymond Aubrac Clermont Ferrand France
8Department of Anesthesia, Hospital Italiano de Buenos Aires, Buenos Aires University, 1179, Buenos Aires, Argentina
9Department of Anesthesia, All India Institute of Medical Sciences, New Delhi 110029, India
10Gastrointestinal Surgery, National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals and University of Nottingham Queen’s Medical Centre NG7 2UH Nottingham UK

Tóm tắt

AbstractBackground

During the last two decades, an increasing number of bariatric surgical procedures have been performed worldwide. There is no consensus regarding optimal perioperative care in bariatric surgery. This review aims to present such a consensus and to provide graded recommendations for elements in an evidence‐based “enhanced” perioperative protocol.

Methods

The English‐language literature between January 1966 and January 2015 was searched, with particular attention paid to meta‐analyses, randomised controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded. After critical appraisal of these studies, the group of authors reached a consensus recommendation.

Results

Although for some elements, recommendations are extrapolated from non‐bariatric settings (mainly colorectal), most recommendations are based on good‐quality trials or meta‐analyses of good‐quality trials.

Conclusions

A comprehensive evidence‐based consensus was reached and is presented in this review by the enhanced recovery after surgery (ERAS) Society. The guidelines were endorsed by the International Association for Surgical Metabolism and Nutrition (IASMEN) and based on the evidence available in the literature for each of the elements of the multimodal perioperative care pathway for patients undergoing bariatric surgery.

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