• Marcos Paulo Gouveia de Oliveira, Gustavo Fernandes, Juliana Fernandes Andrade, Danilo Pereira Barbosa, Pamela França Silva, Ana Carolina Franceschilli Bossi, and Ana Beatriz Monteiro Correa da Costa E Silva.
• Gastrointestinal Surgery Department, Santa Marcelina Itaquera Hospital, Rua Santa Marcelina, 177, 5 D, Vila Carmosina, São Paulo, SP, 08270-085, Brazil. marcosmed97@gmail.com.
• Obes Surg. 2021 Apr 1; 31 (4): 1612-1617.

OverviewThe global prevalence of obesity and increase in bariatric surgeries are burdening the healthcare system. Enhanced recovery postoperative protocols are associated with a reduction in hospitalization costs and length of stay (LOS) and may be an alternative to reduce public health expenses.ObjectiveTo assess the impact of implementing a customized Enhanced Recovery After Bariatric Surgery (ERABS) protocol on hospitalization costs (HC), LOS, and complication rates.SettingSanta Marcelina Hospital, São Paulo, Brazil.MethodsA retrospective electronic health record analysis of patients who underwent laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy and who were cared for within a clinical pathway (CP) protocol (Jan. 2016-Aug. 2018) or after implementation of an ERABS protocol (Aug. 2018-Jun. 2019). The LOS, HC, and complication, readmission, and reoperation rates were compared between the two groups.ResultsEighty-two patients were included in the study (CP, 56, 87.5% women; ERABS, 26, 92.3% women). Hospital LOS and total HC decreased significantly by 32.5% and 15.2%, respectively (both, p < 0.05), after implementation of ERABS. There were no significant differences in 30-day readmission, complication, or reoperation rates.ConclusionThe implementation of a standardized enhanced recovery program resulted in reduced LOS and HC without an increase in perioperative morbidity. The ERABS protocol is cost-effective and can help ease the healthcare burden.

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