Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update.

Erik Stenberg, Luiz Fernando Dos Reis Falcão, Mary O'Kane, Ronald Liem, Dimitri J Pournaras, Paulina Salminen, Richard D Urman, Anupama Wadhwa, Ulf O Gustafsson, Anders Thorell

Journal: World journal of surgery 2022;46(4):729-751

PMID: 34984504

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Abstract

BACKGROUND

This is the second updated Enhanced Recovery After Surgery (ERAS®) Society guideline, presenting a consensus for optimal perioperative care in bariatric surgery and providing recommendations for each ERAS item within the ERAS® protocol.

METHODS

A principal literature search was performed utilizing the Pubmed, EMBASE, Cochrane databases and ClinicalTrials.gov through December 2020, with particular attention paid to meta-analyses, randomized controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. After critical appraisal of these studies, the group of authors reached consensus regarding recommendations.

RESULTS

The quality of evidence for many ERAS interventions remains relatively low in a bariatric setting and evidence-based practices may need to be extrapolated from other surgeries.

CONCLUSION

A comprehensive, updated evidence-based consensus was reached and is presented in this review by the ERAS® Society.

Address: Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. [email protected].; Discipline of Anesthesia, Pain and Critical Care Medicine, Federal University of São Paulo, São Paulo, Brazil.; Dietetic Department, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK.; Department of Surgery, Groene Hart Hospital, Gouda, Netherlands.; Dutch Obesity Clinic, The Hague, Netherlands.; Department of Upper GI and Bariatric/Metabolic Surgery, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, UK.; Department of Surgery, University of Turku, Turku, Finland.; Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.; Department of Anesthesiology, Outcomes Research Institute, Cleveland Clinic, University of Texas Southwestern, Dallas, USA.; Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.; Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.; Department of Surgery, Ersta Hospital, Stockholm, Sweden.

DOI: 10.1007/s00268-021-06394-9

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MeSH Terms: Bariatric Surgery, Consensus, Enhanced Recovery After Surgery, Humans, Perioperative Care, Prospective Studies