ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet2014419-24ometendo-6562Research ArticleОбзор литературыReviewУскоренная реабилитация пациентов после бариатрических операций – современ-ный подходEnhanced recovery after bariatric surgery – a modern approachХациевБекхан БаяловичKhatsievBekkhan Bayalovich

кандидат медицинских наук, заведующий хирургическим отделением клиники эндоскопической и малоинвазивной хирургии

bkhatsiev@yandex.ruКузьминовАлександр НиколаевичKuzminovAleksandr Nikolaevich

кандидат медицинских наук, врач-хирург клиники эндоскопической и малоинвазивной хирургии

dr.kuzminov@gmail.comЯшковЮрий ИвановичYashkovYuriy Ivanovich

д.м.н., профессор

yu@yashkov.ruУзденовНауруз АхматовичUzdenovNauruz Akhmatovich

врач-хирург клиники эндоскопической и малоинвазивной хирургии

dr.nauka@mail.ruСтавропольский государственный медицинский университетРоссияStavropol State Medical UniversityRussian FederationЦентр эндоскопии и литотрипсии (ЦЭЛТ)РоссияEndosurgery and Lithotripsy CenterRussian Federation2014290620141141924Copyright © Хациев Б.Б., Кузьминов А.Н., Яшков Ю.И., Узденов Н.А., 20142014Хациев Б.Б., Кузьминов А.Н., Яшков Ю.И., Узденов Н.А.Khatsiev B.B., Kuzminov A.N., Yashkov Y.I., Uzdenov N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/6562

Протоколы ускоренной реабилитации после операции (Enhanced Recovery After Surgery – ERAS) широко используются в хирургии и продемонстрировали свою эффективность. Несмотря на то, что число статей, посвященных ускоренной реабилитации в бариатрической хирургии, значительно меньше, чем в других областях хирургии, уже накоплено достаточно данных, позволяющих составить рекомендации, основанные на исследованиях с высоким уровнем доказательности. В статье приведен обзор современных данных о методах ускоренной реабилитации, применяемых в бариатрической хирургии. Методы ускоренной реабилитации могут использоваться для оптимизации всех этапов периоперативного ведения пациента и включают данные о подготовке к операции, поддержании электролитного баланса, профилактике послеоперационной тошноты и рвоты, адекватной анальгезии, а также определяются критерии безопасной выписки пациента из стационара. Рекомендации рассчитаны для использования в мультидисциплинарной команде специалистов.

Guidelines for enhanced recovery after surgery (ERAS) are widely used and their efficiency was clearly demonstrated by numerous studies. Number of publications on this topic in bariatric surgery is significantly lower compared with other fields of surgery. However, the data accumulated allow to compose recommendations based on studies with high level of evidence. Authors review existing methods of enhanced recovery in their implementation into bariatric surgery. Enhanced recovery methods can be used to optimize all stages of perioperative care and include data on preoperative preparation, maintenance of electrolyte balance, prevention of postoperative nausea and vomiting, sufficient analgesia and safe discharge form hospital. Suggested guidelines for bariatric surgery are implied to be used by a multidisciplinary team.

бариатрическая хирургияускоренная реабилитацияfast trackbariatric surgeryenhanced recoveryfast trackobesityReferencesLemanu DP, Srinivasa S, Singh PP, Johannsen S, MacCormick AD, Hill AG. Optimizing Perioperative Care in Bariatric Surgery Patients. OBES SURG 2012;22(6):979–990. doi: 10.1007/s11695-012-0648-6.Lemanu DP, Srinivasa S, Singh PP, Johannsen S, MacCormick AD, Hill AG. Optimizing Perioperative Care in Bariatric Surgery Patients. OBES SURG 2012;22(6):979–990. doi: 10.1007/s11695-012-0648-6.Kaufman AS, McNelis J, Slevin M, La Marca C. Bariatric surgery claims – a medico-legal perspective. Obes Surg 2006;16(12):1555–1558. PMID: 17217628. doi: 10.1381/096089206779319482.Kaufman AS, McNelis J, Slevin M, La Marca C. Bariatric surgery claims – a medico-legal perspective. Obes Surg 2006;16(12):1555–1558. PMID: 17217628. doi: 10.1381/096089206779319482.deFreitas DJ, Kasirajan K, Ricotta JJ, et al. Preoperative inpatient hospitalization and risk of perioperative infection following elective vascular procedures. Annals of vascular surgery 2012;26(1):46–54. PMID: 22079458. doi: 10.1016/j.avsg.2011.08.008.deFreitas DJ, Kasirajan K, Ricotta JJ, et al. Preoperative inpatient hospitalization and risk of perioperative infection following elective vascular procedures. Annals of vascular surgery 2012;26(1):46–54. PMID: 22079458. doi: 10.1016/j.avsg.2011.08.008.McLeod R, Fitzgerald W, Sarr M, Members of the Evidence Based Reviews in Surgery G. Canadian Association of General Surgeons and American College of Surgeons evidence based reviews in surgery. 14. Preoperative fasting for adults to prevent perioperative complications. Canadian journal of surgery Journal canadien de chirurgie 2005;48(5):409-411. PMID: 16248141.McLeod R, Fitzgerald W, Sarr M, Members of the Evidence Based Reviews in Surgery G. Canadian Association of General Surgeons and American College of Surgeons evidence based reviews in surgery. 14. Preoperative fasting for adults to prevent perioperative complications. Canadian journal of surgery Journal canadien de chirurgie 2005;48(5):409-411. PMID: 16248141.Noblett SE, Watson DS, Huong H, et al. Pre-operative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal disease : The official journal of the Association of Coloproctology of Great Britain and Ireland 2006;8(7):563–569. PMID: 16919107. doi: 10.1111/j.1463-1318.2006.00965.x.Noblett SE, Watson DS, Huong H, et al. Pre-operative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal disease : The official journal of the Association of Coloproctology of Great Britain and Ireland 2006;8(7):563–569. PMID: 16919107. doi: 10.1111/j.1463-1318.2006.00965.x.Wille-Jorgensen P, Guenaga KF, Matos D, Castro AA. Pre-operative mechanical bowel cleansing or not? an updated meta-analysis. Colorectal disease : The official journal of the Association of Coloproctology of Great Britain and Ireland 2005;7(4):304–310.doi: 10.1111/j.1463-1318.2005.00804.x.Wille-Jorgensen P, Guenaga KF, Matos D, Castro AA. Pre-operative mechanical bowel cleansing or not? an updated meta-analysis. Colorectal disease : The official journal of the Association of Coloproctology of Great Britain and Ireland 2005;7(4):304–310.doi: 10.1111/j.1463-1318.2005.00804.x.Jung B, Pahlman L, Nystrom PO, et al. Multicentre randomized clinical trial of mechanical bowel preparation in elective colonic resection. The British journal of surgery 2007;94(6):689–695. doi: 10.1002/bjs.5816.Jung B, Pahlman L, Nystrom PO, et al. Multicentre randomized clinical trial of mechanical bowel preparation in elective colonic resection. The British journal of surgery 2007;94(6):689–695. doi: 10.1002/bjs.5816.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.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.Becattini C, Agnelli G, Manina G, et al. Venous thromboembolism after laparoscopic bariatric surgery for morbid obesity: clinical burden and prevention. Surgery for obesity and related diseases : Official journal of the American Society for Bariatric Surgery 2012;8(1):108-115. PMID: 22014482. doi: 10.1016/j.soard.2011.09.005.Becattini C, Agnelli G, Manina G, et al. Venous thromboembolism after laparoscopic bariatric surgery for morbid obesity: clinical burden and prevention. Surgery for obesity and related diseases : Official journal of the American Society for Bariatric Surgery 2012;8(1):108-115. PMID: 22014482. doi: 10.1016/j.soard.2011.09.005.Melinek J, Livingston E, Cortina G, Fishbein MC. Autopsy findings following gastric bypass surgery for morbid obesity. Archives of pathology & laboratory medicine 2002;126(9):1091–1095.Melinek J, Livingston E, Cortina G, Fishbein MC. Autopsy findings following gastric bypass surgery for morbid obesity. Archives of pathology & laboratory medicine 2002;126(9):1091–1095.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.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.Frantzides CT, Welle SN, Ruff TM, Frantzides AT. Routine Anticoagulation for Venous Thromboembolism Prevention Following Laparoscopic Gastric Bypass. JSLS 2012;16(1):33–37. PMID: 22906327. doi: 10.4293/108680812X13291597716906.Frantzides CT, Welle SN, Ruff TM, Frantzides AT. Routine Anticoagulation for Venous Thromboembolism Prevention Following Laparoscopic Gastric Bypass. JSLS 2012;16(1):33–37. PMID: 22906327. doi: 10.4293/108680812X13291597716906.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.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.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 laparoscopic and open Roux-en-Y gastric bypass in the United States. Surgical technology international. Surgical technology international 2012;22:72–76. PMID: 23065805.Masoomi H, Nguyen NT, Stamos MJ, Smith BR. Overview of outcomes of laparoscopic 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.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.Holte K, Foss NB, Andersen J, Valentiner L, Lund C, Bie P, et al. Liberal or restrictive fluid administration in fast-track colonic surgery: a randomized, double-blind study. British Journal of Anaesthesia 2007;99(4):500–508. doi: 10.1093/bja/aem211.Holte K, Foss NB, Andersen J, Valentiner L, Lund C, Bie P, et al. Liberal or restrictive fluid administration in fast-track colonic surgery: a randomized, double-blind study. British Journal of Anaesthesia 2007;99(4):500–508. doi: 10.1093/bja/aem211.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.x.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.x.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.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.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.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.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.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.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.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.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.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.Surgical site infection. Vol. CG74. London: National Institute for Health and Care Excellence; 2008.Surgical site infection. Vol. CG74. London: National Institute for Health and Care Excellence; 2008.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.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.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.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.Ruiz Tovar J, Badia JM. Prevention of surgical site infection in abdominal surgery. A critical review of the evidence. Cir Esp 2014;92(4):223–231. PMID: 24411561. doi: 10.1016/j.ciresp.2013.08.003.Ruiz Tovar J, Badia JM. Prevention of surgical site infection in abdominal surgery. A critical review of the evidence. Cir Esp 2014;92(4):223–231. PMID: 24411561. doi: 10.1016/j.ciresp.2013.08.003.dos Santos Moraes, (Iran), Madalosso CAS, Palma LA, da Silva Fornari AC, do Socorro Dourado, (Maria), Scherer T, et al. Hospital Discharge in the Day Following Open Roux-en-Y Gastric Bypass: Is it Feasible and Safe. OBES SURG 2009;19(3):281–286. PMID: 19067087. doi: 10.1007/s11695-008-9779-1. 33.dos Santos Moraes, (Iran), Madalosso CAS, Palma LA, da Silva Fornari AC, do Socorro Dourado, (Maria), Scherer T, et al. Hospital Discharge in the Day Following Open Roux-en-Y Gastric Bypass: Is it Feasible and Safe. OBES SURG 2009;19(3):281–286. PMID: 19067087. doi: 10.1007/s11695-008-9779-1. 33.Moussa AA, Oregan PJ. Prevention of postoperative nausea and vomiting in patients undergoing laparoscopic bariatric surgery-granisetron alone vs granisetron combined with dexamethasone/droperidol. Middle East journal of anesthesiology 2007;19(2):357–367. PMID: 17684876.Moussa AA, Oregan PJ. Prevention of postoperative nausea and vomiting in patients undergoing laparoscopic bariatric surgery-granisetron alone vs granisetron combined with dexamethasone/droperidol. Middle East journal of anesthesiology 2007;19(2):357–367. PMID: 17684876.Golembiewski J, Chernin E, Chopra T. Prevention and treatment of postoperative nausea and vomiting. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists 2005;62(12):1247–1260.Golembiewski J, Chernin E, Chopra T. Prevention and treatment of postoperative nausea and vomiting. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists 2005;62(12):1247–1260.Karanicolas PJ, Smith SE, Kanbur B, Davies E, Guyatt GH. The Impact of Prophylactic Dexamethasone on Nausea and Vomiting After Laparoscopic Cholecystectomy. Annals of Surgery 2008;248(5):751–762. PMID: 18948802. doi: 10.1097/SLA.0b013e3181856024.Karanicolas PJ, Smith SE, Kanbur B, Davies E, Guyatt GH. The Impact of Prophylactic Dexamethasone on Nausea and Vomiting After Laparoscopic Cholecystectomy. Annals of Surgery 2008;248(5):751–762. PMID: 18948802. doi: 10.1097/SLA.0b013e3181856024.Mendes MN, Monteiro Rde S, Martins FA. Prophylaxis of postoperative nausea and vomiting in morbidly obese patients undergoing laparoscopic gastroplasties: a comparative study among three methods. Revista brasileira de anestesiologia 2009;59(5):570–576. PMID: 19784512.Mendes MN, Monteiro Rde S, Martins FA. Prophylaxis of postoperative nausea and vomiting in morbidly obese patients undergoing laparoscopic gastroplasties: a comparative study among three methods. Revista brasileira de anestesiologia 2009;59(5):570–576. PMID: 19784512.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.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.Henzi I, Walder B, Tramer MR. Dexamethasone for the Prevention of Postoperative Nausea and Vomiting: A Quantitative Systematic Review. Anesthesia & Analgesia 2000;90(1):186–194. doi: 10.1097/00000539-200001000-00038.Henzi I, Walder B, Tramer MR. Dexamethasone for the Prevention of Postoperative Nausea and Vomiting: A Quantitative Systematic Review. Anesthesia & Analgesia 2000;90(1):186–194. doi: 10.1097/00000539-200001000-00038.Schumann R. Anaesthesia for bariatric surgery. Best Practice & Research Clinical Anaesthesiology 2011;25(1):83–93. doi: 10.1016/j.bpa.2010.12.006.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.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.Overby, D. Wayne, Kohn GP, Cahan MA, Dixon RG, Stavas JM, Moll S, et al. Risk-Group Targeted Inferior Vena Cava Filter Placement in Gastric Bypass Patients. OBES SURG 2009;19(4):451–455. PMID: 19127387. doi: 10.1007/s11695-008-9794-2.Overby, D. Wayne, Kohn GP, Cahan MA, Dixon RG, Stavas JM, Moll S, et al. Risk-Group Targeted Inferior Vena Cava Filter Placement in Gastric Bypass Patients. OBES SURG 2009;19(4):451–455. PMID: 19127387. doi: 10.1007/s11695-008-9794-2.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.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.Saravanakumar K, Rao SG, Cooper GM. Obesity and ob-stetric anaesthesia. Anaesthesia 2006;61(1):36–48. doi: 10.1111/j.1365-2044.2005.04433.x.Saravanakumar K, Rao SG, Cooper GM. Obesity and ob-stetric anaesthesia. Anaesthesia 2006;61(1):36–48. doi: 10.1111/j.1365-2044.2005.04433.x.Dobesh PP, Wittkowsky AK, Stacy Z, Dager WE, Haines ST, Lopez LM, et al. Key Articles and Guidelines for the Prevention of Venous Thromboembolism. Pharmacotherapy 2009;29(4):410–458. doi: 10.1592/phco.29.4.410.Dobesh PP, Wittkowsky AK, Stacy Z, Dager WE, Haines ST, Lopez LM, et al. Key Articles and Guidelines for the Prevention of Venous Thromboembolism. Pharmacotherapy 2009;29(4):410–458. doi: 10.1592/phco.29.4.410.Kaffarnik M, Utzolino S. Postoperatives Management bei Patienten mit einem BMI>40 kg/m2. Zentralbl Chir 2009;134(01):43–49. doi: 10.1055/s-0028-1098806.Kaffarnik M, Utzolino S. Postoperatives Management bei Patienten mit einem BMI>40 kg/m2. Zentralbl Chir 2009;134(01):43–49. doi: 10.1055/s-0028-1098806.Kehlet H. Multimodal approach to postoperative recovery. Current Opinion in Critical Care 2009;15(4):355–358. doi: 10.1097/MCC.0b013e32832fbbe7.Kehlet H. Multimodal approach to postoperative recovery. Current Opinion in Critical Care 2009;15(4):355–358. doi: 10.1097/MCC.0b013e32832fbbe7.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.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. Fast-track laparoscopic bariatric surgery: a systematic review. Updates Surg 2013;65(2):85–94. PMID: 23371325. doi: 10.1007/s13304-012-0195-7.Elliott JA, Patel VM, Kirresh A, Ashrafian H, Le Roux CW, Olbers T, et al. Fast-track laparoscopic bariatric surgery: a systematic review. Updates Surg 2013;65(2):85–94. PMID: 23371325. doi: 10.1007/s13304-012-0195-7.Harper J, Madan AK, Ternovits CA, Tichansky DS. What happens to patients who do not follow-up after bariatric surgery. The American surgeon 2007;73(2):181–184.Harper J, Madan AK, Ternovits CA, Tichansky DS. What happens to patients who do not follow-up after bariatric surgery. The American surgeon 2007;73(2):181–184.

The authors declare that there are no conflicts of interest present.