#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Clinical practice guidelines for perioperative care in bariatric surgery 2023: Adapted ERAS (enhanced recovery after surgery) guidelines with consensual voting of the working group of the Joint Bariatric and Metabolic Surgery Section of the Czech Surgery Society and Czech Society of Obesitology


Authors: I. Satinský 1,2;  M. Hrubý 3;  P. Šrámková 4;  J. Patka 5;  M. Čierný 6;  P. Babiak 7;  I. Šimonik 8;  P. Schwarz 1;  M. Haluzík 9,10
Authors‘ workplace: Centrum pro léčbu obezity, Nemocnice Havířov, Česká republika 1;  Ústav nelékařských zdravotnických studií, Fakulta veřejných politik, Slezská univerzita v Opavě, Česká republika 2;  Centrum bariatrické a metabolické chirurgie, Krajská nemocnice Liberec, Nemocnice Turnov, Česká republika 3;  Centrum pro léčbu obezity a metabolických poruch, OB klinika, a. s., Praha, Česká republika 4;  Anesteziologicko-resuscitační oddělení, Krajská nemocnice Liberec, Nemocnice Turnov, Česká republika 5;  Chirurgické oddělení, Nemocnice Břeclav, Česká republika 6;  Anesteziologicko-resuscitační oddělení, Nemocnice Břeclav, Česká republika 7;  Chirurgické oddělení, Nemocnice sv. Zdislavy, Mostiště, Česká republika 8;  Centrum diabetologie, Institut klinické a experimentální medicíny, Česká republika 9;  Ústav lékařské biochemie a laboratorní diagnostiky 1. lékařské fakulty Univerzity Karlovy a Všeobecné fakultní nemocnice, Česká republika 10
Published in: Rozhl. Chir., 2023, roč. 102, č. 7, s. 283-297.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2023.102.7.283–297

Overview

Introduction: Currently, bariatric surgery is the most effective treatment for the morbid obesity. It provides sustained weight loss as well as demonstrated positive effects on obesity-related comorbidities. The number of procedures performed worldwide has seen a sharp increase in the past twenty years. Therefore, an effort has been developed to establish a consensus in perioperative care based on best evidence.

Methods: The working group of the Joint Bariatric and Metabolic Surgery Section of the Czech Surgery Society and Czech Society of Obesitology prepared clinical practice guidelines for the ERAS (enhanced recovery after surgery) concept in perioperative care in bariatric surgery. The working group based its guidelines on ERAS guidelines published in 2021. The working group adopted the original text and then adapted the text and added its comments to specific items as appropriate. Electronic voting of all members of the working group was the final phase, by which the strength of consensus was expressed with respect to individual elements of the guidelines.

Results: The Czech working group reached a consensus with ERABS (enhanced recovery after bariatric surgery) guidelines for most elements. The quality of evidence is low for some interventions of the ERAS protocol for bariatric surgery. Therefore, extrapolation from other surgeries and fields is needed for evidence-based practice.

Conclusion: The guidelines are intended for clinical practice in bariatric surgery with the ERAS protocol based on updated evidence and guidelines. It is based on recent and comprehensive ERAS guidelines adopted and adapted by the Czech working group of the Joint Bariatric and Metabolic Surgery Section of the Czech Surgery Society and Czech Society of Obesitology. Some supplementations and specifications are reflected in comments added to the Czech version.

Keywords:

bariatric and metabolic surgery – Enhanced Recovery After Surgery – guidelines for clinical practice


Sources
  1. Angrisani L, Santonicola A, Iovino P, et al. IFSO Worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–3794. doi:10.1007/s11695-018-3450-2.
  2. Parisi A, Desiderio J, Cirocchi R, et al. Enhanced recovery after surgery (ERAS): a systematic review of randomised controlled trials (RCTs) in bariatric surgery. Obes Surg. 2020;30(12):5071–5085. doi:10.1007/s11695-020-05000-6.
  3. Geubbels N, Evren I, Acherman YIZ, et al. Randomized clinical trial of an enhanced recovery after surgery programme versus conventional care in laparoscopic Roux-en-Y gastric bypass surgery. BJS Open 2019;3(3):274–281. doi:10.1002/ bjs5.50143.
  4. Thorell A, MacCormick AD, Awad S, et al. Guidelines for perioperative care in bariatric surgery: Enhanced Recovery after Surgery (ERAS) Society recommendations. World J Surg. 2016;40(9):2065– 2083. doi:10.1007/s00268-016-3492-3.
  5. Stenberg E, Falcão LF, O‘Kane M, et al. Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations: A 2021 Update. World J Surg. 2022;46(4):729–751. doi: 10.1007/ s00268-021-06394-9.
  6. Guyatt GH, Oxman AD, Kunz R, et al. Going from evidence to recommendations. BMJ 2008;336(7652):1049–1051. doi: 10.1136/bmj.39493.646875.AE.
  7. Guyatt GH, Oxman AD, Kunz R, et al. What is „quality of evidence“ and why is it important to clinicians? BMJ. 2008;336(7651):995–998. doi:10.1136/ bmj.39490.551019.BE.
  8. German Association of the Scientific Medical Societies (AWMF) − Standing Guidelines Commission. AWMF guideline manual and rules for guideline development. 1st ed. 2012 English version: http:/ www.awmf.org/leitlinien/awmf-regelw- erk.html.
  9. Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures − 2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, the Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association and American Society of Anesthesiologists executive summary. Endocr Pract. 2019;25(12):1346–1359. doi: 10.4158/ GL-2019-0406.
  10. NIH conference (1991) Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 115(12):956–961.
  11. Obesity: identification, assessment and management. Published 2014. Available at www.nice.org.uk/guidance/cg189 on May 11, 2021.
  12. Rubino F, Nathan DM, Eckel RH, et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: A joint statement by International Diabetes Organizations. Diabetes Care 2016;39(6):861–877. doi:10.2337/dc16-0236.
  13. Eisenberg D, Shikora SA, Aarts E, et al. 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) indications for metabolic and bariatric surgery. Surg Obes Relat Dis. 2022;18(12):1345−1356. doi:10.1016/j. soard.2022.08.013.
  14. Šrámková P, Fried M. Antiobezitika před bariatrickou operací a po ní – jak je využít co nejlépe. Čas Lék čes. 2022(3−4);161:107−113.
  15. Hughes MJ, Hackney RJ, Lamb PJ, et al. Prehabilitation before major abdominal surgery: a systematic review and meta-analysis. World J Surg. 2019; 43(7): 1661–1668. doi:10.1007/s00268-019-04950-y.
  16. Singh PP, Srinivasa S, Lemanu DP, et al. Statins in abdominal surgery: a systematic review. J Am Coll Surg. 2012;214(3): 356–366. doi:10.1016/j.jamcollsurg.2011.11.008.
  17. Ljungqvist O, Jonathan E. Rhoads lecture 2011: Insulin resistance and enhanced recovery after surgery. JPEN J Parenter Enteral Nutr. 2012;36(4):389–398. 10.1177/ 0148607112445580.
  18. Gan TJ, Belani KG, Bergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2020;131(2):411–448. doi:10.1213/ANE.0000000000004833.
  19. Bamgbade OA, Oluwole O, Khaw RR. Perioperative antiemetic therapy for fasttrack laparoscopic bariatric surgery. Obes Surg. 2018;28(5):1296–1301. doi:10.1007/ s11695-017-3009-7.
  20. Reiterer Ch, Kabon B, Zotti O, et al. Effect of goal-directed crystalloid − versus colloid-based fluid strategy on tissue oxygen tension: a randomised controlled trial. Br J Anaesth. 2019;123(6):768–776. doi:10.1016/j.bja.2019.08.027
  21. Gero D, Raptis DA, Vleeschouwers W, et al. Defining global benchmarks in bariatric surgery: a retrospective multicenter analysis of minimally invasive roux-en-y gastric bypass and sleeve gastrectomy. Ann Surg. 2019;270(5):859–867. doi:10.1097/ SLA.0000000000003512.
  22. Zevin B, Aggarwal R, Grantcharov TP. Volume-outcome association in bariatric surgery: a systematic review. Ann Surg. 2012;256(1):60–71. doi:10.1097/SLA.0b013 e3182554c62.
  23. Doumouras AG, Maeda A, Jackson TD. The role of routine abdominal drainage after bariatric surgery: a metabolic and bariatric surgery accreditation and quality improvement program study. Surg Obes Relat Dis. 2017;13(12):1997–2003. doi:10.1016/j.soard.2017.08.019.
  24. Kakkos SK, Caprini JA, Geroulakos G, et al. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism. Cochrane Database Syst Rev. 2016;9(9):Cd005258. doi:10.1002/ 14651858.CD005258.pub3.
  25. Parrott J, Frank L, Rabena R, et al. American society for metabolic and bariatric surgery integrated health nutritional guidelines for the surgical weight loss patient 2016 update: micronutrients. Surg Obes Relat Dis. 2017;13(5):727–741. doi:10.1016/j.soard.2016.12.018.
  26. O‘Kane M, Parretti HM, Pinkney J, et al. British Obesity and Metabolic Surgery Society guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery-2020 update. Obes Rev. 2020;21(11):e13087. doi:10.1111/obr.13087.
  27. Ying VW, Kim SH, Khan KJ, et al. Prophylactic PPI help reduce marginal ulcers after gastric bypass surgery: a systematic review and meta-analysis of cohort studies. Surg Endosc. 2015;29(5):1018–1023. doi:10.1007/s00464-014-3794-1.
  28. Haal S, Gurman MSS, Boerlage TCC, et al. Ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery (UPGRADE): a multicentre, double-blind, randomised, placebo-controlled superiority trial. Lancet Gastroenterol Hepatol. 2021;6(12): 993−1001.  doi:10.1016/2468-1253(21)00301-0.
  29. Tian YL, Cao SG, Liu XD, et al. Shortand long-term outcomes associated with enhanced recovery after surgery protocol vs conventional management in patients undergoing laparoscopic gastrectomy. World J Gastroenterol. 2020; 26(37):5646–5660. doi:10.3748/wjg.v26. i37.5646.
  30. Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations: 2018. World J Surg. 2019;43(3):659–695. doi: 10.1007/ s00268-018-4844-y.
Labels
Surgery Orthopaedics Trauma surgery
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#