Vnitr Lek 2024, 70(1):E20-E32

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

Igor Satinský^{1, 2}, Martin Hrubý³, Petra Šrámková⁴, Jiří Patka⁵, Michal Čierný⁶, Pavol Babiak⁷, Igor Šimoník⁸, Peter Schwarz¹, Martin Haluzík^{9, 10}

¹ 0Ústav lékařské biochemie a laboratorní diagnostiky 1. lékařské fakulty Univerzity Karlovy a Všeobecné fakultní nemocnice, Praha

² Ústav nelékařských zdravotnických studií, Fakulta veřejných politik, Slezská univerzita v Opavě

³ Centrum bariatrické a metabolické chirurgie, Krajská nemocnice Liberec, Nemocnice Turnov

⁴ Centrum pro léčbu obezity a metabolických poruch, OB klinika, a. s., Praha

⁵ Anesteziologicko-resuscitační oddělení, Krajská nemocnice Liberec, Nemocnice Turnov

⁶ Chirurgické oddělení, Nemocnice Břeclav

⁷ Anesteziologicko-resuscitační oddělení, Nemocnice Břeclav

⁸ Chirurgické oddělení, Nemocnice sv. Zdislavy, Mostiště

⁹ Centrum diabetologie, Institut klinické a experimentální medicíny, Praha

Introduction: Bariatric surgery is the most effectice 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 strenght 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, the 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 adaptated 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 (Rozh Chir. 2023;102:283-297. doi:10.33699/PIS2023.102.7.283-297) (1).

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

Published: February 26, 2024  Show citation