СОВРЕМЕННЫЕ СТРАТЕГИИ РЕАБИЛИТАЦИИ ПОСЛЕ БАРИАТРИЧЕСКИХ ОПЕРАЦИЙ: УСКОРЕННЫЙ ПОДХОД К ВОССТАНОВЛЕНИЮ ПАЦИЕНТОВ

Авторы

  • РИЗАЕВ Жасур Алимджанович
  • МИРАХМЕДОВ Гайрат Мирахмедович

Ключевые слова:

хирургия ожирения, протоколы ERAS, послеоперационная реабилитация.

Аннотация

Протоколы ускоренного восстановления после хирургических вмешательств (Enhanced Recovery After Surgery — ERAS) получили широкое распространение в общей хирургической практике и доказали свою высокую клиническую эффективность. Несмотря на то, что число научных публикаций, касающихся внедрения протоколов ERAS в бариатрической хирургии, остается меньшим по сравнению с другими хирургическими направлениями, в настоящее время имеется достаточный массив данных, позволяющих формулировать рекомендации на основе принципов доказательной медицины. Представленный обзор систематизирует современные сведения об использовании элементов ускоренного восстановительного подхода в бариатрических вмешательствах.

Библиографические ссылки

Thorell, A., MacCormick, A. D., Awad, S., Reynolds, N., Roulin, D., Demartines, N., & Ljungqvist, O. (2021). Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: 2021 Update. World Journal of Surgery, 45(9), 2082–2090. https://doi.org/10.1007/s00268-021-06394-9.

Choudhry, A. J., Haddad, N. N., Martin, M. J., Khasawneh, M. A., Sifri, Z. C., & Moazzez, A. (2017). Medical malpractice in bariatric surgery: A review of 140 medicolegal claims. Journal of Gastrointestinal Surgery, 21(1), 146–154.

Becattini C, Agnelli G, Manina G, Nova G, Rondelli F. Venous thromboem bolism after laparoscopic bariatric surgery for morbid obesity: clinical bur den and prevention. Surg Obes Relat Dis. 2012;8(1):108-115. https://doi.org/10.1016/j.soard.2011.09.005

Rizvanović, N., Nesek Adam, V., Čaušević, S., et al. (2023). Effects of preoperative oral carbohydrate loading on neutrophil/lymphocyte ratio and postoperative complications following colorectal cancer surgery: a randomized controlled study. European Surgical Research, 64(2), 278–285.

Kumar, S. M., Anandhi, A., Sureshkumar, S., et al. (2024). Effect of preoperative oral carbohydrate loading on postoperative insulin resistance, patient-perceived well-being, and surgical outcomes in elective colorectal surgery: a randomized controlled trial. Journal of Gastrointestinal Surgery, 28(10), 1654–1660.

Noblett, S. E., Watson, D. S., & Huong, H. (2006). Pre-operative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal Disease, 8(7), 563–569.

Дедов И.И., Мельниченко Г.А., Шестакова М.В., Трошина Е.А., Ма зурина Н.В., Шестакова Е.А., Яшков Ю.И., Неймарк А.Е., Бирюко ва Е.В., Бондаренко И.З., Бордан Н.С., Дзгоева Ф.Х., Ершова Е.В., Комшилова К.А., Мкртумян А.М., Петунина Н.А., Романцова Т.И., Старостина Е.Г., Стронгин Л.Г., Суплотова Л.А., Фадеев В.В. Лечение морбидного ожирения у взрослых. Ожирение и метаболизм. 2018;15(1):53-70.

ASMBS updated position statement on prophylactic measures to reduce the risk of venous thromboembolism in bariatric surgery patients. Society for Metabolic & Bariatric Surgery Clinical Issues Committee. ASMBS updated position statement on prophylactic measures to reduce the risk of venous thromboembolism in bariatric surgery patients. Surgery for obesity and related diseases: Official journal of the American Society for Bariatric Surgery 2013;9(4):493–497.

Thorell A, MacCormick AD, Awad S, et al. Guidelines for perioperative care in bariatric surgery: enhanced recovery after surgery (ERAS) society recommendations. World J Surg. 2016; 40:2065-2083. doi: https://doi.org/10.1007/s00268-016-3492-3

Бокерия Л.А., Затевахин И.И., Кириенко А.И. и др. Российские клини ческие рекомендации по диагностике, лечению и профилактике веноз ных тромбоэмболических осложнений (ВТЭО). Флебология. 2015;9(4-2). Ссылка активна на 05.03.2020.

Flum DR, Belle SH, et al. Longitudinal Assessment of Bariatric Surgery Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. The New England journal of medicine 2009;361(5):445–454. PMID: 19641201. doi: 10.1056/NEJMoa0901836.

Stein PD, Matta F. Pulmonary embolism and deep venous thrombosis fol lowing bariatric surgery. Obes Surg. 2013;23:663-668. https://doi.org/10.1007/s11695-012-0854-2.

Vlug MS, Wind J, Hollmann MW, Ubbink DT, Cense HA, Engel AF, et al. Laparoscopy in Combination with Fast Track Multimodal Management is the Best Perioperative Strategy in Patients Undergoing Colonic Surgery. Annals of Surgery 2011;254(6):868–875. PMID: 21597360. doi: 10.1097/SLA.0b013e31821fd1ce.

Shabanzadeh DM, Sørensen LT. Laparoscopic Surgery Compared With Open Surgery Decreases Surgical Site Infection in Obese Patients. Annals of Surgery 2012;256(6):934–945. PMID: 23108128. doi: 10.1097/SLA.0b013e318269a46b.

Masoomi H, Nguyen NT, Stamos MJ, Smith BR. Overview of outcomes of aparoscopic and open Roux-en-Y gastric bypass in the United States. Surgical technology international. Surgical technology international 2012; 22:72–76. PMID: 23065805.

Soni N. British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients (GIFTASUP): Cassandra's view.. Anaesthesia 2009;64(3):235–238. PMID: 19302633. doi: 10.1111/j.1365-2044.2009.05886_1.x.

Dang JT, Switzer N, Delisle M, Laffin M, Gill R, Birch DW, Karmali S. Predicting venous thromboembolism following laparoscopic bariatric sur gery: development of the BariClot tool using the MBSAQIP database. Surg Endosc. 2019;33(3):821-831. https://doi.org/10.1007/s00464-018-6348.

Bundgaardnielsen M, Secher NH, Kehlet H. ‘Liberal’ vs. ‘restrictive’ perioperative fluid therapy – a critical assessment of the evidence. Acta Anaesthesiologica Scandinavica 2009;53(7):843–851. PMID: 19519723. doi: 10.1111/j.1399-6576.2009.02029.

Wool DB, Lemmens HJM, Brodsky JB, Solomon H, Chong KP, Morton JM.Intraoperative Fluid Replacement and Postoperative Creatine Phosphokinase Levels in Laparoscopic Bariatric Patients. OBES SURG 2010;20(6):698–701. PMID: 20198451. doi: 10.1007/s11695-010-0092-4.

Hillman DR, Platt PR, Eastwood PR. Anesthesia, Sleep, and Upper Airway Collapsibility. Anesthesiology Clinics 2010;28(3):443–455. doi: 10.1016/j.anclin.2010.07.003.

Aubrun F, Valade N, Coriat P, Riou B. Predictive Factors of Severe Postoperative Pain in the Postanesthesia Care Unit. Anesthesia & Analgesia 2008;106(5):1535–1541. PMID: 18420872. doi: 10.1213/ane.0b013e318168b2ce.

Apfel CC, Heidrich FM, Jukar-Rao S, Jalota L, Hornuss C, Whelan RP, et al. Evidence-based analysis of risk factors for post-operative nausea and vomiting. British Journal of Anaesthesia 2012;109(5):742–753. doi: 10.1093/bja/aes276.

Mansour M, Mahmoud AA, Geddawy M. Nonopioid versus opioid based general anesthesia technique for bariatric surgery: A randomized double-blind study. Saudi J Anaesth 2013;7(4):387–391. PMID: 24348288. doi: 10.4103/1658-354X.121045.

Gurusamy KS, Koti R, Davidson BR. Routine abdominal drainage versus no abdominal drainage for uncomplicated laparoscopic cholecystectomy.. Cochrane Database Syst Rev 2013;9. PMID: 24000011. doi: 10.1002/14651858.CD006004.pub4.

Kavuturu S, Rogers AM, Haluck RS. Routine Drain Placement in Roux-en-Y Gastric Bypass: An Expanded Retrospective Comparative Study of 755 Patients and Review of the Literature. OBES SURG 2012;22(1):177–181. PMID: 22101852. doi: 10.1007/s11695-011-0560-5.

Huerta S, Arteaga JR, Sawicki MP, Liu CD, Livingston EH. Assessment of routine elimination of postoperative nasogastric decompression after Roux en-Y gastric bypass. Surgery 2002;132(5):844–848. PMID: 12464869. doi: 10.1067/msy.2002.127678.

Carrère N, Seulin P, Julio CH, Bloom E, Gouzi J, Pradère B. Is Nasogastric or Nasojejunal Decompression Necessary after Gastrectomy? A Prospective Randomized Trial. World J. Surg 2007;31(1):122–127. doi: 10.1007/s00268-006-0430-9.

Finks JF, English WJ, Carlin AM, Krause KR, Share DA, Banerjee M, Birk meyer JD, Birkmeyer NJ. Predicting risk for venous thromboembolism with bariatric surgery. Ann Surg. 2012;255:1100-1104. https://doi.org/10.1097/sla.0b013e31825659d4

Chopra T, Marchaim D, Lynch Y, Kosmidis C, Zhao JJ, Dhar S, et al. Epidemiology and outcomes associated with surgical site infection following bariatric surgery. American Journal of Infection Control 2012;40(9):815–819. PMID: 22325729. doi: 10.1016/j.ajic.2011.10.015.

McCaffrey R, Bishop M, Adonis-Rizzo M, Williamson E, McPherson M, Cruikshank A, Carrier VJ, Sands S, Pigano D, Girard P, Lauzon C. Devel opment and testing of a DVT risk assessment tool: providing evidence of va lidity and reliability. Worldviews Evid Based Nurs. 2007;4(1):14-20. https://doi.org/10.1111/j.1741-6787.2007.00074.x

Ekici A., Ekici M., İleri Ş., Cimen A., Aslan H. Pulmonary embolism in obesity-hypoventilation syndrome. Clin Respir J. 2020;14(11):1099–1104. https://doi.org/10.1111/crj.13241.

Shabanzadeh D.M., Sorensen L.T. Laparoscopic surgery compared with open surgery decreases surgical site infection in obese patients: a systematic review and meta-analysis. Annals of surgery 2012; 256: 6: 934—945.

Mansour M.A., Mahmoud A.A., Geddawy M. Nonopioid versus opioid based general anesthesia technique for bariatric surgery: A randomized double-blind study. Saudi journal of anaesthesia 2013; 7: 4: 387—391.

Gurusamy K.S., Koti R., Davidson B.R. Routine abdominal drainage versus no abdominal drainage for uncomplicated laparoscopic cholecystectomy. The Cochrane database of systematic reviews 2013; 9CD006004.

Kavuturu S., Rogers A.M., Haluck R.S. Routine drain placement in Roux-en-Y gastric bypass: an expanded retrospective comparative study of 755 patients and review of the literature. Obes Surg 2012; 22: 1: 177—181.

Chopra T., Marchaim D., Lynch Y., Kosmidis C., Zhao J.J., Dhar S., Gheyara N., Turner D., Gulish D., Wood M., Alangaden G., Kaye K.S. Epidemiology and outcomes associated with surgical site infection following bariatric surgery. American journal of infection control 2012; 40: 9: 815—819.

Benevides ML, Oliveira, Sérgio S de Souza, de Aguilar-Nascimento JE. The Combination of Haloperidol, Dexamethasone, and Ondansetron for Prevention of Postoperative Nausea and Vomiting in Laparoscopic Sleeve Gastrectomy: a Randomized Double-Blind Trial. OBES SURG 2013;23(9):1389–1396. PMID: 23529851. doi: 10.1007/s11695-013-0923-1.

Witso E. The role of infection-associated risk factors in prosthetic surgery. Hip international : the journal of clinical and experimental research on hip pathology and therapy 2012; 22 Suppl 8: 5—8.

Schumann R. Anaesthesia for bariatric surgery. Best Practice & Research Clinical Anaesthesiology 2011;25(1):83–93. doi: 10.1016/j.bpa.2010.12.006.

Hafermann MJ, Namdar R, Seibold GE, Page RL, 2nd. Effect of intravenous ondansetron on QT interval prolongation in patients with cardiovascular disease and additional risk factors for torsades: a prospective, observational study. Drug, healthcare and patient safety. Drug, healthcare and patient safety 2011;3:53–58. doi: 10.2147/DHPS.S25623.

Ruiz Tovar J., Badia J.M. Prevention of surgical site infection in abdominal surgery. A critical review of the evidence. Cirugia espanola 2014; DOI: 10.1016/j.ciresp.2013.08.003

Magee CJ, Barry J, Javed S, et al. Extended thromboprophylaxis reduces incidence of postoperative venous thromboembolism in laparoscopic bariatric surgery. Surgery for obesity and related diseases: Official journal of the American Society for Bariatric Surgery 2010;6(3):322–325. PMID: 20510295. doi: 10.1016/j.soard.2010.02.046.

Benevides M.L., Oliveira S.S., De Aguilar-Nascimento J.E. The combination of haloperidol, dexamethasone, and ondansetron for prevention of postoperative nausea and vomiting in laparoscopic sleeve gastrectomy: a randomized double-blind trial. Obes Surg 2013; 23: 9: 1389—1396.

Hafermann M.J., Namdar R., Seibold G.E., Page R.L. 2nd. Efect of intravenous ondansetron on QT interval prolongation in patients with cardiovascular disease and additional risk factors for torsades: a prospective, observational study. Drug, healthcare and patient safety 2011; 353—358.

Magee C.J., Barry J., Javed S., Macadam R., Kerrigan D. Extended thromboprophylaxis reduces incidence of postoperative venous thromboembolism in laparoscopic bariatric surgery. Surgery for obesity and related diseases: ofcial journal of the American Society for Bariatric Surgery 2010; 6: 3: 322—325.

Joliat GR, Labgaa I, Petermann D, et al. Cost-benefit analysis of an enhanced recovery protocol for pancreaticoduodenectomy. Br J Surg. 2015;102:1676-1683. doi: https://doi.org/10.1002/bjs.9957

Mechanick JI, Youdim A, Jones DB, Timothy Garvey, W, Hurley DL, Molly McMahon, M, et al. Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient—2013 Update: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Surgery for Obesity and Related Diseases 2013;9(2):159–191. doi: 10.1016/j.soard.2012.12.010.

Elliott JA, Patel VM, Kirresh A, Ashrafian H, Le Roux CW, Olbers T, et al. Fasttrack laparoscopic bariatric surgery: a systematic review. Updates Surg 2013;65(2):85–94. PMID: 23371325. doi: 10.1007/s13304-012-0195-7.

Lemanu DP, Singh PP, Berridge K, et al. Randomized clinical trial of enhanced recovery versus standard care after laparoscopic sleeve gastrectomy. Br J Surg. 2013;100:482-489. doi: https://doi.org/ 10.1002/bjs.9026

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Опубликован

2025-08-08