Comparative outcomes of ERAS and conventional methods in laparoscopic sleeve gastrectomy: a 5-Year prospective cohort study in Saudi Arabia
Abstract Background The burden of obesity in Saudi Arabia is partly addressed with Laparoscopic Sleeve Gastrectomy (LSG), a bariatric surgical option, but perioperative complications and prolonged hospital stays persist. Enhanced Recovery After Surgery (ERAS) aims to improve postoperative outcomes....
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-025-04036-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849226185093939200 |
|---|---|
| author | Hager Aref Tahir Yunus Moheyeldin Farghaly Yasser ElDahshan Haseeb Javed Khan Dalia Alsaadi Francis Albert A. Jacobo Ayan ahmed Amel Mohamed Ali Y Saber Khairia Ali Farah Alefranji Edilberta Miranda Omar Dakkak |
| author_facet | Hager Aref Tahir Yunus Moheyeldin Farghaly Yasser ElDahshan Haseeb Javed Khan Dalia Alsaadi Francis Albert A. Jacobo Ayan ahmed Amel Mohamed Ali Y Saber Khairia Ali Farah Alefranji Edilberta Miranda Omar Dakkak |
| author_sort | Hager Aref |
| collection | DOAJ |
| description | Abstract Background The burden of obesity in Saudi Arabia is partly addressed with Laparoscopic Sleeve Gastrectomy (LSG), a bariatric surgical option, but perioperative complications and prolonged hospital stays persist. Enhanced Recovery After Surgery (ERAS) aims to improve postoperative outcomes. Objectives To compare the peri-operative LSG outcomes among patients receiving ERAS and conventional bariatric procedures (non-ERAS). Methods A prospective cohort study design involving patients receiving conventional LSG care (non-ERAS) (n = 50) and those receiving ERAS protocol (n = 44) at International Medical Centre, Jeddah, Saudi Arabia. The ERAS protocol consisted of preoperative, intraoperative, and postoperative components, including patient education, fluid management, early mobilization, and pain management. Outcomes were compared between the two groups in terms of length of stay, postoperative ambulation, Clavien-Dindo graded postoperative complications, 30-day readmission, mortality and healthcare costs, followed by a five-year follow-up. Results In total the number of participants was 94 patients. The ERAS group had a slightly shorter length of stay (2.05 days vs. 2.20 days) and significantly lower healthcare costs (SAR43,337 vs. SAR46,040, p < 0.05) compared to the non-ERAS group. The ERAS group had a lower incidence of postoperative Clavien-Dindo-graded complications, including wound infection, atelectasis, and pneumonia. The total length of the surgical procedure did not differ significantly (p < 0.05). Remarkably, 100% of patients in the ERAS group were out-of-bed on postoperative day (POD) zero compared to only 25% in the non-ERAS group. On the day of the operation, a greater percentage of patients in the ERAS group (58%) began oral intake than in the conventional care group (42%). There were no observable statistical differences in analgesic benefits in both groups (p = 0.543), 6 h after discharge from the post-anaesthesia care unit and at POD 1 (p = 0.08). At 5-year follow-up, the ERAS group had a better prognosis with fewer complications. At 5-year follow-up, a higher percentage of the ERAS group did not report any complication compared to the non-ERAS group (61% vs. 51%). Conclusion Implementation of ERAS in LSG improved postoperative outcomes, including shorter length of stay, better mobilization, lower healthcare costs, and fewer complications. This demonstrates the effectiveness of ERAS in LSG and provides valuable insights for improving perioperative bariatric care practices. |
| format | Article |
| id | doaj-art-123c7db051f042258b0613ae0ac4a9bb |
| institution | Kabale University |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-123c7db051f042258b0613ae0ac4a9bb2025-08-24T11:33:03ZengBMCBMC Gastroenterology1471-230X2025-08-0125111310.1186/s12876-025-04036-1Comparative outcomes of ERAS and conventional methods in laparoscopic sleeve gastrectomy: a 5-Year prospective cohort study in Saudi ArabiaHager Aref0Tahir Yunus1Moheyeldin Farghaly2Yasser ElDahshan3Haseeb Javed Khan4Dalia Alsaadi5Francis Albert A. Jacobo6Ayan ahmed7Amel Mohamed8Ali Y Saber9Khairia Ali10Farah Alefranji11Edilberta Miranda12Omar Dakkak13Department of Surgery, Andalusia Group HospitalDepartment of Surgery, Evercare HospitalDepartment of Anesthesia, International Medical CenterDepartment of Anesthesia, International Medical CenterDepartment of Surgery, Evercare HospitalDepartment of Quality, International Medical CenterOperation room, International Medical CenterDepartment of Nursing, International Medical CenterDepartment of Nursing, International Medical CenterDepartment of Pharmacy, International Medical CenterDepartment of Nursing, International Medical CenterDepartment of Nursing, International Medical CenterDepartment of Nursing, International Medical CenterDepartment of Surgery, International Medical CenterAbstract Background The burden of obesity in Saudi Arabia is partly addressed with Laparoscopic Sleeve Gastrectomy (LSG), a bariatric surgical option, but perioperative complications and prolonged hospital stays persist. Enhanced Recovery After Surgery (ERAS) aims to improve postoperative outcomes. Objectives To compare the peri-operative LSG outcomes among patients receiving ERAS and conventional bariatric procedures (non-ERAS). Methods A prospective cohort study design involving patients receiving conventional LSG care (non-ERAS) (n = 50) and those receiving ERAS protocol (n = 44) at International Medical Centre, Jeddah, Saudi Arabia. The ERAS protocol consisted of preoperative, intraoperative, and postoperative components, including patient education, fluid management, early mobilization, and pain management. Outcomes were compared between the two groups in terms of length of stay, postoperative ambulation, Clavien-Dindo graded postoperative complications, 30-day readmission, mortality and healthcare costs, followed by a five-year follow-up. Results In total the number of participants was 94 patients. The ERAS group had a slightly shorter length of stay (2.05 days vs. 2.20 days) and significantly lower healthcare costs (SAR43,337 vs. SAR46,040, p < 0.05) compared to the non-ERAS group. The ERAS group had a lower incidence of postoperative Clavien-Dindo-graded complications, including wound infection, atelectasis, and pneumonia. The total length of the surgical procedure did not differ significantly (p < 0.05). Remarkably, 100% of patients in the ERAS group were out-of-bed on postoperative day (POD) zero compared to only 25% in the non-ERAS group. On the day of the operation, a greater percentage of patients in the ERAS group (58%) began oral intake than in the conventional care group (42%). There were no observable statistical differences in analgesic benefits in both groups (p = 0.543), 6 h after discharge from the post-anaesthesia care unit and at POD 1 (p = 0.08). At 5-year follow-up, the ERAS group had a better prognosis with fewer complications. At 5-year follow-up, a higher percentage of the ERAS group did not report any complication compared to the non-ERAS group (61% vs. 51%). Conclusion Implementation of ERAS in LSG improved postoperative outcomes, including shorter length of stay, better mobilization, lower healthcare costs, and fewer complications. This demonstrates the effectiveness of ERAS in LSG and provides valuable insights for improving perioperative bariatric care practices.https://doi.org/10.1186/s12876-025-04036-1ERASLaparoscopic sleeve gastrectomyPerioperative outcomesLength of hospitalizationCost-effectiveness |
| spellingShingle | Hager Aref Tahir Yunus Moheyeldin Farghaly Yasser ElDahshan Haseeb Javed Khan Dalia Alsaadi Francis Albert A. Jacobo Ayan ahmed Amel Mohamed Ali Y Saber Khairia Ali Farah Alefranji Edilberta Miranda Omar Dakkak Comparative outcomes of ERAS and conventional methods in laparoscopic sleeve gastrectomy: a 5-Year prospective cohort study in Saudi Arabia BMC Gastroenterology ERAS Laparoscopic sleeve gastrectomy Perioperative outcomes Length of hospitalization Cost-effectiveness |
| title | Comparative outcomes of ERAS and conventional methods in laparoscopic sleeve gastrectomy: a 5-Year prospective cohort study in Saudi Arabia |
| title_full | Comparative outcomes of ERAS and conventional methods in laparoscopic sleeve gastrectomy: a 5-Year prospective cohort study in Saudi Arabia |
| title_fullStr | Comparative outcomes of ERAS and conventional methods in laparoscopic sleeve gastrectomy: a 5-Year prospective cohort study in Saudi Arabia |
| title_full_unstemmed | Comparative outcomes of ERAS and conventional methods in laparoscopic sleeve gastrectomy: a 5-Year prospective cohort study in Saudi Arabia |
| title_short | Comparative outcomes of ERAS and conventional methods in laparoscopic sleeve gastrectomy: a 5-Year prospective cohort study in Saudi Arabia |
| title_sort | comparative outcomes of eras and conventional methods in laparoscopic sleeve gastrectomy a 5 year prospective cohort study in saudi arabia |
| topic | ERAS Laparoscopic sleeve gastrectomy Perioperative outcomes Length of hospitalization Cost-effectiveness |
| url | https://doi.org/10.1186/s12876-025-04036-1 |
| work_keys_str_mv | AT hageraref comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT tahiryunus comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT moheyeldinfarghaly comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT yassereldahshan comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT haseebjavedkhan comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT daliaalsaadi comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT francisalbertajacobo comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT ayanahmed comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT amelmohamed comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT aliysaber comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT khairiaali comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT farahalefranji comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT edilbertamiranda comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia AT omardakkak comparativeoutcomesoferasandconventionalmethodsinlaparoscopicsleevegastrectomya5yearprospectivecohortstudyinsaudiarabia |