Enhanced Recovery after Surgery (ERAS): a Systematic Review of Randomised Controlled Trials (RCTs) in Bariatric Surgery

Obes Surg. 2020 Dec;30(12):5071-5085. doi: 10.1007/s11695-020-05000-6. Epub 2020 Sep 26.

Abstract

Objective: Our aim was to conduct an up-to-date systematic review of randomised controlled trials (RCTs) to determine the benefits and harms of enhanced recovery after surgery (ERAS) programme in bariatric surgery.

Methods: MEDLINE, Embase, PubMed, CINAHL and the Cochrane Library were searched for RCTs on ERAS versus standard care (SC) until April 2020. The primary endpoint was the length of hospital stay (LOS).

Results: Five RCTs included a total of 610 procedures. ERAS adoption is capable of significantly reducing LOS (MD of - 0.51; 95% CI - 0.92 to - 0.10; P = 0.01) and postoperative nausea and vomiting (PONV) (OR 0.42; 95% CI 0.19 to 0.95; P = 0.04). No significant differences in terms of adverse events and readmissions.

Conclusions: The implementation of ERAS in bariatric surgery produces a significant reduction in LOS and PONV.

Keywords: Bariatric surgery; ERAS; Enhanced recovery aftersurgery; Meta-analysis; Metabolic surgery; Randomised controlled trials; Sleeve gastrectomy; Systematic review; gastric bypass.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Bariatric Surgery*
  • Enhanced Recovery After Surgery*
  • Humans
  • Length of Stay
  • Obesity, Morbid* / surgery
  • Postoperative Complications / prevention & control
  • Postoperative Nausea and Vomiting / prevention & control