Background

Enhanced recovery after surgery (ERAS) protocols are evidence-based, multimodal approaches to optimize patient recovery and minimize complications. The purpose of our study was to evaluate clinical outcomes following the implementation of an ERAS protocol for adolescents undergoing bariatric surgery.

Methods

We performed a single-institution retrospective review of adolescents who underwent bariatric surgery between August 2021 and November 2022. Unpaired t-tests and Fisher’s exact test were used to compare means between groups and categorical factors.

Results

43 patients were included in the study, 21 who participated in the ERAS protocol and 22 control patients. ERAS cohort was 52% female, with a median age of 17.5 years and average body mass index (BMI) of 46.3. The non-ERAS cohort was 59% female, with a median age of 16.7 years and average BMI of 44.9. There were no significant differences between baseline characteristics. Patients in the ERAS group had a shorter length of stay (1.5 days vs. 2.0 days, p = 0.01), faster time to oral intake (10.7 hours vs. 21.5 hours, p=0.001), and lower morphine milligram equivalents (13.0 vs. 26.7, p=.01). There were no significant differences between returns to the emergency department (ED) within 30 days (3 vs. 2, p= 0.66) or rehospitalizations (0 vs. 0, p = 1.0).

Conclusions

Preliminary data suggests an ERAS protocol is safe and effective in adolescent metabolic bariatric surgery resulting in shorter time to oral intake, reduced narcotic requirements, and shorter hospital lengths of stay with no increase in return visits to the ED or rehospitalizations.