Evidence map›Paper›PMID 30120584›Full record

ArticleSurgical endoscopy2019

An ERAS protocol for bariatric surgery: is it safe to discharge on post-operative day 1?

Jenny Lam, Toshiaki Suzuki, David Bernstein, Beiqun Zhao, Carlos Maeda, Thach Pham, Bryan J Sandler, Garth R Jacobsen, Joslin N Cheverie, Santiago Horgan

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  11. SEX AND ASA CLASSIFICATION, NOT FASTING TIME, ARE ASSOCIATED WITH THE LIKELIHOOD OF COMPLICATIONS IN THE POSTOPERATIVE PERIOD.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024
    Observational
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  19. Endoscopic management of early GI tract bleeding in a group of bariatric patients undergoing a fast track protocol.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2021
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jenny LamDivision of Minimally Invasive Surgery, University of San Diego, California, San Diego, CA, USA. jennylam86@gmail.com.ORCID http://orcid.org/0000-0002-9059-6228
Toshiaki SuzukiDivision of Minimally Invasive Surgery, University of San Diego, California, San Diego, CA, USA.
David BernsteinDivision of Minimally Invasive Surgery, University of San Diego, California, San Diego, CA, USA.
Beiqun ZhaoDivision of Minimally Invasive Surgery, University of San Diego, California, San Diego, CA, USA.ORCID http://orcid.org/0000-0003-2181-3783
Carlos MaedaDivision of Minimally Invasive Surgery, University of San Diego, California, San Diego, CA, USA.ORCID http://orcid.org/0000-0002-0824-7599
Thach PhamDivision of Minimally Invasive Surgery, University of San Diego, California, San Diego, CA, USA.ORCID http://orcid.org/0000-0001-9663-8081
Bryan J SandlerDivision of Minimally Invasive Surgery, University of San Diego, California, San Diego, CA, USA.
Garth R JacobsenDivision of Minimally Invasive Surgery, University of San Diego, California, San Diego, CA, USA.
Joslin N CheverieDivision of Minimally Invasive Surgery, University of San Diego, California, San Diego, CA, USA.
Santiago HorganDivision of Minimally Invasive Surgery, University of San Diego, California, San Diego, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaparoscopic sleeve gastrectomy is the most commonly performed bariatric surgery in the world. Enhanced recovery after surgery (ERAS) protocols have been shown to reduce complications and decrease length of stay for various types of surgeries. In this study, we propose an ERAS protocol for laparoscopic sleeve gastrectomy and compare the clinical outcomes with patients who received standard care.

methodsWe performed a single-institution retrospective analysis in patients who underwent laparoscopic sleeve gastrectomy from February 2015 to December 2017. Patients were stratified into standard care and ERAS protocol groups. The ERAS protocol consisted of goal-directed patient education, specific pre- and post-op multi-modal medication regimen, early ambulation, and early oral intake. Patients were discharged on their first post-operative day if they met appropriate post-surgical milestones. The primary outcomes were length of stay, 7- and 30-day readmission rates, and complication rates. Secondary outcomes included anti-emetic and pain medication utilization, post-operative emesis episodes per day, post-operative pain scores, and mortality.

resultsWe included 214 consecutive patients who underwent sleeve gastrectomy, 130 were in the ERAS group and 84 were in the standard care group. Median hospital stay was significantly shorter in the ERAS group compared to the standard care group (1 vs. 2 days; p < 0.001). There were no differences in 7- or 30-day readmission rates (1.5 vs. 1.2%; p = 0.838, 2.3 vs. 2.4%; p = 0.966) or post-operative complications (6.2 vs. 3.6%; p = 0.410). The ERAS group also had decreased median intra-operative opioid consumption and self-reported pain scores on post-operative day 1 (27.5 MME vs. 27.4 MME; p = 0.044, 3.3 vs. 3.9; p = 0.046). Mortality rate was 0% overall.

conclusionA cost-effective ERAS protocol for laparoscopic sleeve gastrectomy results in shorter length of stay, without increase in peri-operative morbidity or readmission rates.

Indexed as

Enhanced Recovery After SurgeryAdultBariatric SurgeryClinical ProtocolsCost-Benefit AnalysisEarly AmbulationFemaleGastrectomyHumansLaparoscopyLength of StayMaleMiddle AgedPatient DischargePatient ReadmissionPostoperative ComplicationsBariatric surgeryEnhanced recovery after surgeryERAS protocolSleeve gastrectomy

Identifiers

PMID30120584

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.