Application of the ERAS protocol in patients treated surgically due to severe obesity

Introduction
Enhanced Recovery After Surgery (ERAS) protocol includes appropriate preoperative preparation, proper surgery procedure and ensuring proper postoperative care. It is recommended that patients with obesity should be treated according to the ERAS protocol due to high risk of postoperative complications.

Aim of the study
Evaluate the implementation of an Enhanced Recovery After Surgery (ERAS) protocol in patients operated on due to severe obesity.

Material and methods
This analysis included 412 patients with morbid obesity (260 female/152 male, mean BMI 48.02 kg/m²) who had undergone laparoscopic bariatric surgery. Perioperative care was conducted according to the ERAS protocol. Examined factors included oral nutrition tolerance, time until mobilisation after surgery, requirement for opioids, length of hospitalisation, complications, and readmission rate.

Results
During the first 24 postoperative hours, oral administration of liquids was tolerated by 402 (97.57%) patients and 399 (96.8%) were fully mobile. In 107 (25.98%) patients it was necessary to administer opioids to relieve pain. The average time of hospitalisation was 2.92 days (range 1-12 days). Postoperative complications occurred in 7.29% of patients (mainly rhabdomyolysis). Four patients (0.97%) required readmission within 30 days of surgery.

Conclusions
The introduction of the principles of the ERAS protocol allowed for reduced hospitalisation times without an increased rate of complications or readmissions.