Enhanced Recovery After Surgery and next-day discharge after laparoscopic Roux-en-Y gastric bypass
Bibliographic record
Abstract
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common bariatric procedure, but patients often experience extended inpatient stays. Given that Enhanced Recovery After Surgery (ERAS) protocols aim to expedite recovery and discharge, we sought to evaluate the impact of introducing an overnight short-stay unit with ERAS protocols, along with transfer protocols for patients requiring prolonged care. METHODS: We retrospectively reviewed prospectively collected data on LRYGBs performed between November 2017 and December 2020. Postoperative evaluations were conducted 16-21 hours after surgery. Patients were educated about potential complications and required to stay within 1 hour of a tertiary centre for 7 days. We analyzed descriptive outcomes including length of stay (LOS), 30-day emergency department (ED) presentations, and 7-day and 30-day readmissions. RESULTS: Among the 439 patients, the postoperative day 1 discharge rate was 94.8%, and the day 2 discharge rate was 1.8%. A small proportion of patients (2.7%) required transfer for anticipated prolonged LOS, primarily for delayed intra-abdominal hemorrhage requiring reoperation (66.7%) and as a precautionary measure for technically challenging procedures (16.7%). Two brief admissions to the intensive care unit occurred, with no deaths. Overall, 45 (10.3%) patients presented to the ED within 30 days, 12 (2.7%) patients were readmitted within 7 days, and 18 (4.1%) patients were readmitted within 30 days. Gastrointestinal intolerance was the most common reason for readmission. CONCLUSION: An ERAS protocol for LRYGB enabled safe next-day discharge for 94.8% of patients. Rates of ED presentation and readmission aligned with existing literature, supporting the feasibility of next-day discharge for appropriately selected patients. These findings contribute to the evidence base for optimizing postoperative care and enhancing patient outcomes in bariatric surgery.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".