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Fast-Track Bariatric Surgery Improves Perioperative Care and Logistics Compared to Conventional Care

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Abstract

Background

Due to the increased incidence of morbid obesity, the demand for bariatric surgery is increasing. Therefore, the methods for optimising perioperative care for the improvement of surgical outcome and to increase efficacy are necessary. The aim of this prospective matched cohort study is to objectify the effect of the fast-track surgery (FTS) programme in patients undergoing primary Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) surgery compared to conventional perioperative care (CPC).

Methods

This study compared the perioperative outcome data of two groups of 75 consecutive morbid obese patients who underwent a primary LRYGB according to international guidelines in the periods January 2011–April 2011 (CPC group) and April 2012–June 2012 (FTS group). The two groups were matched for age and sex. Primary endpoints were surgery and hospitalisation time, while secondary endpoints were intraoperative medication use and complication rates.

Results

Baseline patient characteristics for age, sex, weight and ASA classification were similar (p > 0.05) for CPC and FTS patients. BMI and waist circumference were significantly lower (p < 0.05) in the FTS compared to CPC. The total time from arrival at the operating room to the arrival at the recovery was reduced from 119 to 82 min (p < 0.001). Surgery time was reduced from 80 to 56 min (p < 0.001); mean hospital stay was reduced from 65 to 43 h (p < 0.001). Major complications occurred in 3 versus 4 % in the FTS and CPC, respectively.

Conclusions

The introduction of a fast-track programme after primary LRYGB improves short-term recovery and may reduces direct hospital-related resources.

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Conflict of Interest

The authors declare that they have no conflict of interest and no funding was provided.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding

This study was performed without grants or fees.

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Authors and Affiliations

  1. Department of Surgery, Rijnstate Hospital Arnhem, Intern post number 1190, Post Box 9555, 6800 TA, Arnhem, The Netherlands

    Kemal Dogan, Linda Kraaij, Edo O. Aarts, Parweez Koehestanie, Theo J. Aufenacker, Ignace M. C. Janssen & Frits J. Berends

  2. Department of Anesthesia, Rijnstate Hospital Arnhem, Arnhem, The Netherlands

    Edwin Hammink

  3. Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands

    Cees J. H. M. van Laarhoven

Authors
  1. Kemal Dogan
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  2. Linda Kraaij
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  3. Edo O. Aarts
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  4. Parweez Koehestanie
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  5. Edwin Hammink
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  6. Cees J. H. M. van Laarhoven
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  7. Theo J. Aufenacker
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  8. Ignace M. C. Janssen
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  9. Frits J. Berends
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Corresponding author

Correspondence to Kemal Dogan.

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Dogan, K., Kraaij, L., Aarts, E.O. et al. Fast-Track Bariatric Surgery Improves Perioperative Care and Logistics Compared to Conventional Care. OBES SURG 25, 28–35 (2015). https://doi.org/10.1007/s11695-014-1355-2

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  • DOI: https://doi.org/10.1007/s11695-014-1355-2

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