Randomized clinical trial of enhanced recovery versus standard care after laparoscopic sleeve gastrectomy

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dc.contributor.author Lemanu, Daniel en
dc.contributor.author Singh, PP en
dc.contributor.author Berridge, K en
dc.contributor.author Burr, M en
dc.contributor.author Birch, C en
dc.contributor.author Babor, R en
dc.contributor.author MacCormick, Andrew en
dc.contributor.author Arroll, Bruce en
dc.contributor.author Hill, Andrew en
dc.date.accessioned 2017-07-19T02:47:36Z en
dc.date.available 2012-11-01 en
dc.date.issued 2013-03 en
dc.identifier.citation British Journal of Surgery, 100(4):482-489 Mar 2013 en
dc.identifier.issn 0007-1323 en
dc.identifier.uri http://hdl.handle.net/2292/34322 en
dc.description.abstract BACKGROUND: Optimized perioperative care within an enhanced recovery after surgery (ERAS) protocol is designed to reduce morbidity after surgery, resulting in a shorter hospital stay. The present study evaluated this approach in the context of sleeve gastrectomy for patients with morbid obesity. METHODS: Patients were allocated to perioperative care according to a bariatric ERAS protocol or a control group that received standard care. These groups were also compared with a historical group of patients who underwent laparoscopic sleeve gastrectomy at the same institution between 2006 and 2010, selected using matched propensity scores. The primary outcome was median length of hospital stay. Secondary outcomes included readmission rates, postoperative morbidity, postoperative fatigue and mean cost per patient. RESULTS: Of 116 patients included in the analysis, 78 were allocated to the ERAS (40) or control (38) group and there were 38 in the historical group. There were no differences in baseline characteristics between groups. Median hospital stay was significantly shorter in the ERAS group (1 day) than in the control (2 days; P < 0·001) and historical (3 days; P < 0·001) groups. It was also shorter in the control group than in the historical group (P = 0·010). There was no difference in readmission rates, postoperative complications or postoperative fatigue. The mean cost per patient was significantly higher in the historical group than in the ERAS (P = 0·010) and control (P = 0·018) groups. CONCLUSION: The ERAS protocol in the setting of bariatric surgery shortened hospital stay and was cost-effective. There was no increase in perioperative morbidity. REGISTRATION NUMBER: NCT01303809 (http://www.clinicaltrials.gov). en
dc.format.medium Print-Electronic en
dc.language English en
dc.publisher John Wiley & Sons Inc. en
dc.relation.ispartofseries British Journal of Surgery en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://sherpa.ac.uk/romeo/issn/0007-1323/ https://authorservices.wiley.com/author-resources/Journal-Authors/licensing-open-access/open-access/self-archiving.html en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Humans en
dc.subject Obesity, Morbid en
dc.subject Postoperative Complications en
dc.subject Laparoscopy en
dc.subject Treatment Outcome en
dc.subject Clinical Protocols en
dc.subject Length of Stay en
dc.subject Perioperative Care en
dc.subject Gastrectomy en
dc.subject Surgical Procedures, Elective en
dc.subject Analysis of Variance en
dc.subject Recovery of Function en
dc.subject Adult en
dc.subject Cost-Benefit Analysis en
dc.subject Female en
dc.subject Male en
dc.title Randomized clinical trial of enhanced recovery versus standard care after laparoscopic sleeve gastrectomy en
dc.type Journal Article en
dc.identifier.doi 10.1002/bjs.9026 en
pubs.issue 4 en
pubs.begin-page 482 en
pubs.volume 100 en
dc.identifier.pmid 23339040 en
pubs.author-url http://onlinelibrary.wiley.com/doi/10.1002/bjs.9026/abstract en
pubs.end-page 489 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 372632 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Population Health en
pubs.org-id Gen.Practice& Primary Hlthcare en
pubs.org-id School of Medicine en
pubs.org-id South Auckland clinical school en
pubs.org-id Surgery Department en
dc.identifier.eissn 1365-2168 en
pubs.record-created-at-source-date 2017-07-19 en
pubs.dimensions-id 23339040 en

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