Complications in Patients Undergoing Laparoscopic Bariatric Surgery in an ERABS-optimized, High-Volume, Single Center During 2020 and 2021

Katrine Stryhn^{1

2}, Lærke Alstrup^{1

2}, Claus Riber¹, Michael Ørting^{3

4}, Rakin Hadad⁵, Jan Hvistendahl^{6

7}, Carsten Tollund⁸, Niels Boye^{9

10

11}, Steen B Haugaard^{2

9

12}, Peter Funch-Jensen^{13

14

15

16}

Affiliations

¹ Department of Surgery, Aleris Hospitals, Copenhagen Department, Gyngemose Parkvej 66, 2860, Søborg, Denmark.
² Institute of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
³ Department of Surgery, Aleris Hospitals, Aarhus Department, Brendstrupgårdsvej 21, 8200, Aarhus, Denmark.
⁴ Department of Surgery, Aleris Hospitals, Esbjerg Department, Bavnehøjvej 2, 6700, Esbjerg, Denmark.
⁵ Department of Cardiology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
⁶ Department of Anesthesiology, Aleris Hospitals, Aarhus Department, Brendstrupgårdsvej 21, 8200, Aarhus, Denmark.
⁷ Department of Anesthesiology, Aleris Hospitals, Esbjerg Department, Bavnehøjvej 2, 6700, Esbjerg, Denmark.
⁸ Department of Anesthesiology, Aleris Hospitals, Copenhagen Department, Gyngemose Parkvej 66, 2860, Søborg, Denmark.
⁹ Department of Endocrinology, Aleris Hospitals, Copenhagen Department, Gyngemose Parkvej 66, 2860, Søborg, Denmark.
¹⁰ Department of Endocrinology, Aleris Hospitals, Aarhus Department, Brendstrupgårdsvej 21, 8200, Aarhus, Denmark.
¹¹ Department of Endocrinology, Aleris Hospitals, Esbjerg Department, Bavnehøjvej 2, 6700, Esbjerg, Denmark.
¹² Department of Endocrinology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
¹³ Department of Surgery, Aleris Hospitals, Copenhagen Department, Gyngemose Parkvej 66, 2860, Søborg, Denmark. funchjensen@gmail.com.
¹⁴ Department of Surgery, Aleris Hospitals, Aarhus Department, Brendstrupgårdsvej 21, 8200, Aarhus, Denmark. funchjensen@gmail.com.
¹⁵ Department of Surgery, Aleris Hospitals, Esbjerg Department, Bavnehøjvej 2, 6700, Esbjerg, Denmark. funchjensen@gmail.com.
¹⁶ Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus, Denmark. funchjensen@gmail.com.

PMID: 37199830
PMCID: PMC10289944
DOI: 10.1007/s11695-023-06596-1

Observational Study

Complications in Patients Undergoing Laparoscopic Bariatric Surgery in an ERABS-optimized, High-Volume, Single Center During 2020 and 2021

Katrine Stryhn et al. Obes Surg. 2023 Jul.

. 2023 Jul;33(7):2064-2071.

doi: 10.1007/s11695-023-06596-1. Epub 2023 May 18.

Authors

Affiliations

¹ Department of Surgery, Aleris Hospitals, Copenhagen Department, Gyngemose Parkvej 66, 2860, Søborg, Denmark.
² Institute of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
³ Department of Surgery, Aleris Hospitals, Aarhus Department, Brendstrupgårdsvej 21, 8200, Aarhus, Denmark.
⁴ Department of Surgery, Aleris Hospitals, Esbjerg Department, Bavnehøjvej 2, 6700, Esbjerg, Denmark.
⁵ Department of Cardiology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
⁶ Department of Anesthesiology, Aleris Hospitals, Aarhus Department, Brendstrupgårdsvej 21, 8200, Aarhus, Denmark.
⁷ Department of Anesthesiology, Aleris Hospitals, Esbjerg Department, Bavnehøjvej 2, 6700, Esbjerg, Denmark.
⁸ Department of Anesthesiology, Aleris Hospitals, Copenhagen Department, Gyngemose Parkvej 66, 2860, Søborg, Denmark.
⁹ Department of Endocrinology, Aleris Hospitals, Copenhagen Department, Gyngemose Parkvej 66, 2860, Søborg, Denmark.
¹⁰ Department of Endocrinology, Aleris Hospitals, Aarhus Department, Brendstrupgårdsvej 21, 8200, Aarhus, Denmark.
¹¹ Department of Endocrinology, Aleris Hospitals, Esbjerg Department, Bavnehøjvej 2, 6700, Esbjerg, Denmark.
¹² Department of Endocrinology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
¹³ Department of Surgery, Aleris Hospitals, Copenhagen Department, Gyngemose Parkvej 66, 2860, Søborg, Denmark. funchjensen@gmail.com.
¹⁴ Department of Surgery, Aleris Hospitals, Aarhus Department, Brendstrupgårdsvej 21, 8200, Aarhus, Denmark. funchjensen@gmail.com.
¹⁵ Department of Surgery, Aleris Hospitals, Esbjerg Department, Bavnehøjvej 2, 6700, Esbjerg, Denmark. funchjensen@gmail.com.
¹⁶ Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus, Denmark. funchjensen@gmail.com.

PMID: 37199830
PMCID: PMC10289944
DOI: 10.1007/s11695-023-06596-1

Abstract

Purpose: Complication rates after fast-track optimization in bariatric surgery are varying. The aim of this study was to identify short-term complications in patients undergoing laparoscopic sleeve gastrectomy (SG) in an ERABS (enhanced recovery after bariatric surgery) optimized setup.

Materials and methods: This study is an observational analysis of a consecutive cohort of 1600 patients undergoing SG at an ERABS-optimized, private hospital during 2020 and 2021. Primary outcomes were length of stay, mortality, readmissions, reoperations, and complications according to the Clavien-Dindo classification (CDC) within postoperative day (POD) 30 and 90. Secondary outcomes were weight loss and quality of life (QoL) according to Moorehead-Ardelt questionnaires during the first postoperative year.

Results: Primary outcomes: 99.1% of patients were discharged within POD 1. The 90-day mortality rate was zero. There were 1% readmissions and 1.2% reoperations within POD 30. Total 30-day complication rate was 4.6%, where 3.4% accounted for CDC grades ≤ II, and 1.3% accounted for CDC grade III. There were zero grade IV-V complications.

Secondary outcomes: One year after surgery, weight loss was substantial (p < 0.001), with an excess weight loss of 71.9%, and QoL had significantly increased (p < 0.001).

Conclusion: This study demonstrates that the use of an ERABS protocol in bariatric surgery does not compromise neither safety nor efficacy. Complication rates were low, and weight loss was significant. This study thus provides strong arguments that ERABS programs are beneficial in bariatric surgery.

Keywords: Bariatric surgery; Clavien-Dindo classification; ERABS; ERAS; Fast-track surgery; Sleeve gastrectomy.

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Conflict of interest statement

Katrine Stryhn, Lærke Alstrup, Claus Riber, Michael Ørting, Rakin Hadad, Jan Hvistendahl, Carsten Tollund, Niels Boye, and Steen B. Haugaard declare no conflict of interest. Peter Funch-Jensen declares potential conflicts of interest, as he has received research grants from Medtronic, Johnson&Johnson, and AstraZeneca, and holds shares in Novo Nordisk A/S.

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References

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Complications in Patients Undergoing Laparoscopic Bariatric Surgery in an ERABS-optimized, High-Volume, Single Center During 2020 and 2021

Affiliations

Complications in Patients Undergoing Laparoscopic Bariatric Surgery in an ERABS-optimized, High-Volume, Single Center During 2020 and 2021

Authors

Affiliations

Abstract

Conflict of interest statement

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