Postoperative Care and Functional Recovery After Laparoscopic Sleeve Gastrectomy vs. Laparoscopic Roux-en-Y Gastric Bypass Among Patients Under ERAS Protocol
Autor: | Jan Witowski, Jan Kulawik, Mateusz Wierdak, Magdalena Pisarska, Tomasz Stefura, Piotr Małczak, Michał Wysocki, Michał Pędziwiatr, Piotr Major, Andrzej Budzyński |
---|---|
Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty Sleeve gastrectomy Gastric bypass Original Contributions Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Oral fluid intake 03 medical and health sciences Postoperative Complications 0302 clinical medicine Gastrectomy medicine Humans ERAS Postoperative Period Retrospective Studies Bariatric surgery Postoperative Care Laparoscopic sleeve gastrectomy Nutrition and Dietetics business.industry Incidence Incidence (epidemiology) Recovery of Function Length of Stay Middle Aged Functional recovery Roux-en-Y anastomosis Obesity Morbid Surgery Critical Pathways Female Laparoscopy 030211 gastroenterology & hepatology medicine.symptom business Postoperative nausea and vomiting |
Zdroj: | Obesity Surgery |
ISSN: | 1708-0428 0960-8923 |
Popis: | Background The most commonly performed bariatric procedures are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). There are major differences between LSG and LRYGB during postoperative period. Optimization of the postoperative care may be achieved by using enhanced recovery after surgery (ERAS) protocol, which allows earlier functional recovery. Purpose The aim was to assess differences in the course of postoperative care conducted in accordance with ERAS protocol among patients after LSG and LRYGB. Material and Methods Data concerning patients treated for morbid obesity were prospectively gathered in one academic center. Patients were divided into two groups: LSG (n = 364, 63.41%) and LRYGB (n = 210, 36.59%). Multiple factors were used as endpoints to determine the influence of the type of bariatric procedure on postoperative course. Results The rate of postoperative nausea and vomiting and incidence of intravenous fluid administration during the operation was higher in LSG group. LRYGB patients were able to tolerate higher oral fluid intake volumes during the first and the second postoperative day. Mean diuresis during the second and the third postoperative day was significantly higher in LRYGB group. Administration of diuretics and painkillers was comparable between groups, while the risk of fever after the operation was higher in LRYGB group. Mean length of stay was higher in LSG group (LRYGB vs. LSG, 3.46 days ± 1.58 vs. 3.64 days ± 4.41, p = 0.039). Conclusions In our opinion, postoperative treatment after LSG requires more supervision and longer time until functional recovery is achieved. |
Databáze: | OpenAIRE |
Externí odkaz: |