Influence of a checklist -based management model on postoperative complication rates and hospitalization time after metabolic and bariatric surgery.

INTRODUCTION: Metabolic and bariatric surgery (MBS) is associated with various postoperative complications and extended hospital stays. Standardized management protocols may enhance patient outcomes. AIM: This study aimed to evaluate the impact of a checklist-based management protocol on postoperative recovery, length of hospital stay (LOS), and complication rates in patients undergoing laparoscopic MBS. MATERIALS AND METHODS: A retrospective analysis was conducted on 209 patients who underwent laparoscopic MBS between December 2021 and December 2022. The patients were divided into 2 groups based on the perioperative management protocol used. The observational group (n = 112) received checklist-based management, while the control group (n = 97) received standard care. Primary outcomes included LOS, time to first flatus, and time to first mobilization. Secondary outcomes comprised postoperative complications classified according to the Clavien-Dindo scale, postoperative nausea and vomiting (PONV), and analgesic consumption. Health literacy and self-efficacy were assessed using the Newest Vital Sign (NVS) questionnaire and the Self-Rated Abilities for Health Practices (SRAHP) scale. RESULTS: The observational group demonstrated shorter median (interquartile range) LOS (4 [4-5] vs 6 [5-7] d; P <⁠0.001), earlier mean (SD) first flatus (36.76 [10.23] vs 48.32 [12.62] h), and shorter mean time to first mobilization (12.58 [4.68] vs 18.5 [6.29] h), as compared with the control group. The total complication rate was lower in the observational group (4.46% vs 16.49%; P = 0.004), and this cohort also showed lower incidence of PONV and reduced analgesic consumption in comparison with the controls. There were no intergroup differences in the NVS or SRAHP scores before application of the checklist-based management, but postmanagement, the observational group scored higher. CONCLUSIONS: Checklist-based perioperative management was associated with improved postoperative recovery, reduced complications, as well as enhanced health literacy and self-efficacy in the patients undergoing MBS.