【医脉通】2016+ERAS建议:减肥手术围术期护理指南.pdf

【医脉通】2016+ERAS建议:减肥手术围术期护理指南.pdf

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World J Surg DOI 10.1007/s00268-016-3492-3 SCIENTIFIC REVIEW Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations A. Thorell1 • A. D. MacCormick2,3 • S. Awad4,5 • N. Reynolds4 • D. Roulin6 • N. Demartines6 • M. Vignaud7 • 8 9 10 A. Alvarez • P. M. Singh • D. N. Lobo ´ ´ Societe Internationale de Chirurgie 2016 Abstract Background During the last two decades, an increasing number of bariatric surgical procedures have been per- formed worldwide. There is no consensus regarding optimal perioperative care in bariatric surgery. This review aims to present such a consensus and to provide graded recommendations for elements in an evidence-based ‘‘enhanced’’ perioperative protocol. Methods The English-language literature between January 1966 and January 2015 was searched, with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded. After critical appraisal of these studies, the group of authors reached a consensus recommendation. Results Although for some elements, recommendations are extrapolated from non-bariatric settings (mainly col- orectal), most recommendations are based on good-quality trials or meta-analyses of good-quality trials. Conclusions A comprehensive evidence-based consensus was reached and is presented in this review by the enhanced recovery after surgery (ERAS) Society. The guidelines were endorsed by the International Association for Surgical Metabolism and Nutrition (IASMEN) and based on the evidence available in the literature for each of the elements of the multimodal perioperative care pathway for patients undergoing bariatri

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