Monocentric experience and promoting analysis of performing enhanced recovery after surgery (ERAS) in bariatric and metabolic surgery

Objective To compare the difference between enhanced recovery after surgery (ERAS) and traditional surgery treatment in the perioperative period of bariatric and metabolic surgery, and analyze the problems in the implementation of ERAS at present. Methods The clinical data of 34 patients with obesity or type 2 diabetes treated in our bariatric and metabolic surgery center from November 2014 to November 2016 were retrospectively analyzed. The patients were divided into traditional group and Enhanced recovery after surgery (ERAS) group according to the time Enhanced recovery after surgery (ERAS) was performed. ERAS group paid more attention to preoperative education and respiratory function training, without dwelling gastric tube, catheter, without dwelling abdominal drainage tube or short time dwelling after operation. The control group was treated according to the perioperative measures of traditional gastrointestinal surgery, the difference of postoperative recovery time, average hospitalization time, postoperative pain score, postoperative food intake and activity time between the two groups were compared. The problems of ERAS implementation were analyzed and discussed. Results The average postoperative hospitalization time in ERAS group was shorter, (3.6±0.7) d vs.(8.3±2.8) d,P<0.05. The NRS score of postoperative pain in ERAS group was lower than that in control group, (3.3±0.8) vs. (5.5±1.3), P<0.05. In the ERAS group, the abdominal drainage tube was not retained or the retention time was shorter than that in the control group, and the intestinal function recovered faster. With a shorter time kept in bed ,(0.8±0.5) d vs. (2.6±0.7) d, P<0.05.The anus exhaust time of the ERAS group was earlier than that of the control group ,(0.4±0.4) d vs. (3.6±0.6) d, P<0.05. The patients in ERAS group were given a total fluid or clear fluid diet on the second day after operation. The patients in the control group were given whole fluid or clear diet after anus exhaust and the gastric tube was removed. Conclusions In the perioperative treatment of bariatric and metabolic surgery, the protocol of ERAS treatment is better than that of traditional perioperative treatment and is worth implementing. Key words: Enhanced recovery after surgery (ERAS); Bariatric and metabolic surgery; Peri-operative treatment