Enhanced Recovery After Surgery Facilitates Next Day Discharge for Laparoscopic Roux-en-Y Gastric Bypass: Experience from a Provincial Referral Program
Bibliographic record
Abstract
Abstract Introduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common bariatric procedure, but patients often experience extended inpatient stays. Enhanced recovery after surgery (ERAS) protocols aim to expedite recovery and discharge. In the province of Manitoba, Canada, the Centre for Metabolic and Bariatric Surgery (CMBS) is dedicated to providing bariatric care to the population. To enable earlier discharge, an overnight short-stay unit with ERAS protocols was introduced, along with transfer protocols for patients requiring prolonged care. Methods We retrospectively reviewed prospectively collected data on LRYGBs performed from November 2017 to December 2020. Surgical indications included BMI ≥ 35 with comorbidities or BMI 40–55 without comorbidities, approved by a multidisciplinary bariatric team. Postoperative evaluations were conducted 16–21 hours post-surgery. Patients were educated about potential complications and required to reside within one hour of a tertiary center for seven days. This study reports descriptive outcomes: length of stay (LOS), 30-day emergency room (ER) presentations, 7-day readmissions, and 30-day readmissions. Results Among the 439 LRYGB patients, the postoperative day 1 discharge rate was 94.8%, and day 2 discharge rate was 1.8%. A small proportion (2.7%, n = 12) required transfer due to anticipated prolonged LOS, primarily for delayed intraabdominal hemorrhage (66.7%) requiring reoperation and precautionary measures for technically challenging procedures (16.7%). Two brief ICU admissions occurred, with no mortalities. ER presentation rate within 30 days was 10.3% (n = 45), 7-day readmission rate was 2.7% (n = 12), and 30-day readmission rate was 4.1% (n = 18). Gastrointestinal intolerance was the most common reason for readmission. Conclusion Implementing an ERAS protocol for LRYGB enabled safe next-day discharge for 94.8% of patients. ER presentation and readmission rates aligned with existing literature, supporting the feasibility of next-day discharge for appropriately selected bariatric patients. These findings contribute to the evidence base for optimizing postoperative care and enhancing patient outcomes in bariatric surgery.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".