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impact analysis of a fast track protocol implementation after bariatric laparoscopic roux en y gastric bypass in a general surgery unit

Setting: fast track protocols after bariatric surgery had been firstly introduced in large-volume specialized bariatric centers, demonstrating to improve patient’s recovery and hospitalisation; however, feasibility and safety should be still investigated in general surgery units with medium-volume bariatric operations. Objectives: the aim of this study was to assess feasibility, safety and cost-efficacy of implementation of Enhanced Recovery After Bariatric Surgery (ERABS) criteria to bariatric surgery in a medium-volume center. Methods: from October 2014 to January 2017 clinical records of all consecutive patients operated for Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) by experienced surgeons (i.e who performed at least 50 procedures) were retrospectively collected and analysed. Data included demographic and clinical features, operative remarks, hospitalisation, postoperative complications and re-admissions after discharge. Patients were divided in two groups: group A (treated with conventional protocol) and group B (treated by ERABS protocol). Student’s T-test and CHI-square test were used when appropriate. A p-value <0.05 was considered significant. Results: the overall sample of the study consisted of 88 patients were included in the study: the two preand post-ERABS groups were homogeneous in terms of gender, age, Body Mass Index (BMI) at the beginning of the path, at discharge and one month after surgery, copathologies associated with obesity, previous abdominal and bariatric surgery. Regarding the surgical procedure, statistically significant shorter operative times were found in the ERABS group with an average of 67.25 vs 97.2 minutes (p<0.001). Moreover, ERABS group had significant shorter stay in Intensive Care Unit (ICU) (0.02 days’ vs 0.32, p=0.014) and semi-intensive care unit (SICU) (0.23 vs 2.02 days p<0.001). No differences were found in terms of postoperative complications, neither in re-intervention or re-admission rate after discharge. Conclusions: The implementation of ERABS protocol in a General and Emergency Surgery Unit with bariatric activity demonstrated to be safe and feasible, leading to reduction of operative times and ICU admission without increasing complications, reintervention or re-hospitalization rates. Citation: Vecchioni I, Rapicetta C, Cartelli CM, Vaccaro S, Annessi V, et al. (2019) Impact Analysis of a Fast Track Protocol Implementation After Bariatric Laparoscopic Roux-En-Y Gastric Bypass in A General Surgery Unit. J Surg 4: 1271. DOI: 10.29011/2575-9760.001271 2 Volume 04; Issue 16 J Surg, an open access journal ISSN: 2575-9760