Gastroenterologie
a hepatologie

Practical clinical recommendations for perioperative care in bariatric surgery 2023: adaptation of ERAS (Enhanced Recovery After Surgery) recommendations with consensual voting of working group of Joint Section of Bariatric and Metabolic Surgery of Czech

Igor Satinský ^{Orcid.org  1}, Martin Hrubý², Petra Šrámková³, Jiří Patka⁴, Michal Čierný⁵, P. Babiak⁶, Igor Šimoník⁷, Peter Schwarz⁸, Martin Haluzík ^{Orcid.org  9,10}

+ Affiliation
¹ Ústav ošetřovatelství, Fakulta veřejných politik, Slezská univerzita v Opavě
² Centrum bariatrické a metabolické chirurgie, Krajská nemocnice Liberec a. s. – Nemocnice Turnov
³ OB klinika a.s. – Centrum pro léčbu obezity a metabolických onemocnění, Praha
⁴ Anesteziologicko-resuscitační oddělení, Krajská nemocnice Liberec a.s. – Nemocnice Turnov
⁵ Chirurgické oddělení, Nemocnice Břeclav
⁶ Anesteziologicko-resuscitační oddělení, Nemocnice Břeclav
⁷ Chirurgické oddělení, Nemocnice sv. Zdislavy, Mostiště
⁸ Centrum pro léčbu obezity, Nemocnice Havířov, p.o.
⁹ Ústav lékařské biochemie a laboratorní diagnostiky, 1. LF UK a VFN v Praze
¹⁰ Endokrinologický ústav, Praha

Summary

Introduction: Bariatric surgery is the most effective treatment for the morbid obesity. It results in sustained weight loss as well as pronounced effects on obesity-related comorbidities. In the last twenty years the number of procedures performed worldwide increased. Therefore, the effort to establish a consensus in perioperative care based on best evidence in this issue is evident. Methods: Working Group of Joint Section of Bariatric and Metabolic Surgery of Czech Surgery Society and Czech Obesitology Society reached practical recommendations for ERAS (Enhanced Recovery After Surgery) in perioperative care in bariatric surgery. It issued from ERAS recommendations published in 2021. Working group adopted the original text, consequently adapted and in particular cases affixed its commentary. The electronic voting of all members of working group was the final phase, by which the strength of consensus of particular elements was expressed. Results: The Czech working group reached the consensus with recommendations ERABS (Enhanced Recovery After Bariatric Surgery) in the most elements. For some interventions of ERAS protocol for bariatric surgery the quality of evidence is low. Therefore, evidence-based practices may need to be extrapolated from other surgeries. Conclusion: The recommendation is appointed for clinical practice in bariatric surgery with protocol ERAS based on updated evidence and recommendations. It is based on recent and comprehensive ERAS recommendation, which was adopted and adapted by the Czech working group of Joint Section of Bariatric and Metabolic Surgery of Czech Surgery Society and Czech Obesitology Society. The Czech version contents some supplementations and specifications in commentaries. Original article was published in Rozhledy v chirurgii [1].

Keywords

bariatric and metabolic surgery, Enhanced Recovery After Surgery, practical clinical recommendations

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