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Master Thesis

La RAAC en chirurgie bariatrique : résultats à moyen terme de l'implantation d'un protocole de RAAC, étude monocentrique rétrospective au CHU de Caen sur 697 patients consécutifs entre le 1/01/17 et le 31/12/19

Abstract : The aim of this study was to evaluate the mid-term results of the implementation of an ERAS protocol in bariatric surgery inspired by Thorell's guidelines. This is a retrospective study of 697 patients operated on between 1/01/2017 and 31/12/2019. The primary endpoint was to assess morbidity at 30 and 90 days. The secondary endpoint was to identify predictive factors of ERAS failure. A LOS> 2 days defines ERAS failures (ERAS-F) and a LOS< or equal to 2 days ERAS succes (ERAS-S). Our median LOS was 2 days. Readmission rates at 30 and 90 days were 6.6 and 9.38%. Severe complications at 30 and 90 days were 2.75 and 4.24%. Surgical or endoscopic interventions rate were 2.58% and 4.08% at 30 and 90 days. 148 patients were in the ERAS-F group or 21.23%. In univariate analysis, revisional surgery emerges as a factor in ERAS-F (p< 0.00001). The multivariate analysis found 5 independent predictors of ERAS failure corresponding to psychiatric history (p= 0.01), diabetes with insulin (p< 0.0001), anticoagulants (p< 0.00001), distance to the referral center > 100km (p= 0.006) and presence of gallstone on US scan (p= 0.02). The implementation of our ERAS protocol in bariatric surgery has stable results in terms of LOS and morbidity. Psychiatric history, diabetes on insulin, distance greater than 100 km, anticoagulants, and the presence of gallstone on US scan are predictors of length of stay > 2 days. Further studies would be necessary with the creation of an ERAS failure risk score.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03326983
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Submitted on : Thursday, August 26, 2021 - 4:31:30 PM
Last modification on : Tuesday, October 19, 2021 - 11:34:51 PM
Long-term archiving on: : Saturday, November 27, 2021 - 6:38:53 PM

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  • HAL Id : dumas-03326983, version 1

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Coralie Lacroix. La RAAC en chirurgie bariatrique : résultats à moyen terme de l'implantation d'un protocole de RAAC, étude monocentrique rétrospective au CHU de Caen sur 697 patients consécutifs entre le 1/01/17 et le 31/12/19. Médecine humaine et pathologie. 2021. ⟨dumas-03326983⟩

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