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Enhanced Recovery after Bariatric Surgery: Systematic Review and Meta-Analysis
Open accessAbstract
Enhanced recovery after surgery (ERAS) protocol is well established in many surgical disciplines and leads to a decrease in the length of hospital stay and morbidity. Multimodal protocols have also been introduced to bariatric surgery. This review aims to evaluate the current literature on ERAS in obesity surgery and to conduct a meta-analysis of primary and secondary outcomes. MEDLINE, Embase, Scopus and Cochrane Library were searched for eligible studies. Key journals were hand-searched. We analysed data up to May 2016. Eligible studies had to contain four described ERAS protocol elements. The primary outcome was the length of hospital stay; the secondary outcomes included overall morbidity, specific complications, mortality, readmissions and costs. Random effect meta-analyses were undertaken. The initial search yielded 1151 articles. Thorough evaluation resulted in 11 papers, which were analysed. The meta-analysis of the length of stay presented a significant reduction standard mean difference (Std. MD) = -2.39 (-3.89, -0.89), p = 0.002. The analysis of overall morbidity, specific complications and Clavien-Dindo classification showed no significant variations among the study groups. ERAS protocol in bariatric surgery leads to the reduction of the length of hospital stay while maintaining no or low influence on morbidity.
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In two meta-analyses of 11 observational and randomized studies, no difference was found in mortality between ERAS and standard care in bariatric surgery (RR 0.4, 95% CI 0.1 to 2.2).
“Two meta-analyses of 11 observational and randomized studies addressed the comparative effect of ERAS versus standard care in bariatric surgery [1, 2, 65, 66] No differences were found in major (OR 0.94, 95% CI 0.58 to 1.51) and minor postoperative complications (OR 0.88, 95% CI 0.55 to 1.41), and mortality (RR 0.4, 95% CI 0.1 to 2.2).”
In two meta-analyses of 11 observational and randomized studies, no difference was found in minor postoperative complications between ERAS and standard care in bariatric surgery (OR 0.88, 95% CI 0.55 to 1.41).
“Two meta-analyses of 11 observational and randomized studies addressed the comparative effect of ERAS versus standard care in bariatric surgery [1, 2, 65, 66] No differences were found in major (OR 0.94, 95% CI 0.58 to 1.51) and minor postoperative complications (OR 0.88, 95% CI 0.55 to 1.41), and mortality (RR 0.4, 95% CI 0.1 to 2.2).”
In two meta-analyses of 11 observational and randomized studies, no difference was found in major postoperative complications between ERAS and standard care in bariatric surgery (OR 0.94, 95% CI 0.58 to 1.51).
“Two meta-analyses of 11 observational and randomized studies addressed the comparative effect of ERAS versus standard care in bariatric surgery [1, 2, 65, 66] No differences were found in major (OR 0.94, 95% CI 0.58 to 1.51) and minor postoperative complications (OR 0.88, 95% CI 0.55 to 1.41), and mortality (RR 0.4, 95% CI 0.1 to 2.2).”
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“Although this approach has shown benefits in terms of reduced hospital stay, reduction of morbidity has not been observed in a recent meta-analysis.(52)”
Metadata
- Authors
- Małczak, P., Pisarska, M., Piotr, M., Wysocki, M., Budzyński, A., & Pędziwiatr, M.
- Affiliations
- Jagiellonian University (PL)
- Corresponding author
- Pędziwiatr, Michał
- Venue
- Obesity Surgery
- Published
- 2016-11-06
- Volume
- 27
- Issue
- 1
- Pages
- 226-235
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- PMC
- PMC5187372
- OpenAlex
- W2546468672
- Cited by
- 302
- References
- 37
- Citations by year
- 2026: 12 · 2025: 11 · 2024: 41 · 2023: 30 · 2022: 39 · 2021: 38 · 2020: 49 · 2019: 26 · 2018: 43 · 2017: 13
- FWCI
- 5.41
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Obesity Surgery (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Jagiellonian University Repository (Jagiellonian University) (submittedVersion, cc-by-nc-nd)
- Homo Politicus (Academy of Humanities and Economics in Lodz) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Nausea and vomiting management
- Keywords
- enhanced recovery after surgery, bariatric surgery
- MeSH terms
- Humans, Length of Stay, Obesity, Morbid, Postoperative Complications, Comorbidity, Recovery of Function, Bariatric Surgery
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