Document Detail


Randomized clinical trial of enhanced recovery versus standard care after laparoscopic sleeve gastrectomy.
MedLine Citation:
PMID:  23339040     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Optimized perioperative care within an enhanced recovery after surgery (ERAS) protocol is designed to reduce morbidity after surgery, resulting in a shorter hospital stay. The present study evaluated this approach in the context of sleeve gastrectomy for patients with morbid obesity.
METHODS: Patients were allocated to perioperative care according to a bariatric ERAS protocol or a control group that received standard care. These groups were also compared with a historical group of patients who underwent laparoscopic sleeve gastrectomy at the same institution between 2006 and 2010, selected using matched propensity scores. The primary outcome was median length of hospital stay. Secondary outcomes included readmission rates, postoperative morbidity, postoperative fatigue and mean cost per patient.
RESULTS: Of 116 patients included in the analysis, 78 were allocated to the ERAS (40) or control (38) group and there were 38 in the historical group. There were no differences in baseline characteristics between groups. Median hospital stay was significantly shorter in the ERAS group (1 day) than in the control (2 days; P < 0·001) and historical (3 days; P < 0·001) groups. It was also shorter in the control group than in the historical group (P = 0·010). There was no difference in readmission rates, postoperative complications or postoperative fatigue. The mean cost per patient was significantly higher in the historical group than in the ERAS (P = 0·010) and control (P = 0·018) groups.
CONCLUSION: The ERAS protocol in the setting of bariatric surgery shortened hospital stay and was cost-effective. There was no increase in perioperative morbidity.
REGISTRATION NUMBER: NCT01303809 (http://www.clinicaltrials.gov).
Authors:
D P Lemanu; P P Singh; K Berridge; M Burr; C Birch; R Babor; A D MacCormick; B Arroll; A G Hill
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2013-01-21
Journal Detail:
Title:  The British journal of surgery     Volume:  100     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-04     Completed Date:  2013-04-04     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  482-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01303809
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Clinical Protocols
Cost-Benefit Analysis
Female
Gastrectomy / economics,  methods*
Humans
Laparoscopy / economics,  methods*
Length of Stay
Male
Obesity, Morbid / economics,  surgery*
Perioperative Care / economics,  methods*
Postoperative Complications / economics,  etiology
Recovery of Function
Surgical Procedures, Elective / economics,  methods
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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