Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update

Erik Stenberg, Luiz Fernando Dos Reis Falcão, Mary O'Kane, Ronald Liem, Dimitri J Pournaras, Paulina Salminen, Richard D Urman, Anupama Wadhwa, Ulf O Gustafsson, Anders Thorell, Erik Stenberg, Luiz Fernando Dos Reis Falcão, Mary O'Kane, Ronald Liem, Dimitri J Pournaras, Paulina Salminen, Richard D Urman, Anupama Wadhwa, Ulf O Gustafsson, Anders Thorell

Abstract

Background: This is the second updated Enhanced Recovery After Surgery (ERAS®) Society guideline, presenting a consensus for optimal perioperative care in bariatric surgery and providing recommendations for each ERAS item within the ERAS® protocol.

Methods: A principal literature search was performed utilizing the Pubmed, EMBASE, Cochrane databases and ClinicalTrials.gov through December 2020, with particular attention paid to meta-analyses, randomized controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. After critical appraisal of these studies, the group of authors reached consensus regarding recommendations.

Results: The quality of evidence for many ERAS interventions remains relatively low in a bariatric setting and evidence-based practices may need to be extrapolated from other surgeries.

Conclusion: A comprehensive, updated evidence-based consensus was reached and is presented in this review by the ERAS® Society.

Conflict of interest statement

ES has received a speaker honorarium from Johnson & Johnson Medical. LF has received speaker honorarium from Merck Sharp & Dohme, Pfizer and Baxter. MK has received speaker honoraria and personal fees from NovoNordisk, speaker honoraria from Johnson & Johnson Medical, and is member of the IFSO Executive Board and Chair of the IFSO Integrated health Committee, Trustee of the ASO, Committee Member of the BDA Obesity Specialist Group, and Member of the Byband Sleeve Trial Management Group. RL has received speaker honorarium from Johnson & Johnson Medical, and Medtronic, and is the past president of the DSMBS. DP has received consulting fees and speaker honorarium from Johnson & Johnson Medical, speaker honorarium from Medtronic and NovoNordisk. PS has received speaker honorarium from OrionPharma and Merck, and is a member of the BEST-study data safety monitoring committee. RU reports grants and/or consulting fees from Merck, Medtronic, AcelRx, Acacia, Heron and Pfizer; grant support from NIH, NSF and AHRQ. He also reports leadership roles in the ERAS USA and ISPCOP societies. AW is the President of ISPCOP. UG is a member of the ERAS Society Executive committee. AT has received unrestricted research grants (to institution) from Ethicon Endo-Surgery, is a member of advisory board for Novo Nordisk and Ethicon Endo-Surgery and has received speakers honoraria from Kabi Fresenius and Ethicon Endo-Surgery.

© 2021. The Author(s).

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