Discussion
comorbidity, tachycardia
COLLAPSE, POSTOPERATIVE BLEEDING
In adult patients who undergo primary bariatric surgery, an outpatient pathway supported with telemonitoring is clinically comparable to standard overnight bariatrics in terms of textbook-outcome. Both approaches reached primary endpoint results above Dutch average. Also, the patient-preferred outpatient recovery pathway with remote monitoring resulted in significantly fewer hospitalization days without compromising patient satisfaction and safety.Statistically the outpatient surgery protocol was neither inferior, nor non-inferior to the standard pathway. An explanation could be that the standard group had a higher outcome score (98%) than the expected 96% on which the sample size is based [This study evaluated same-day discharge for both sleeve gastrectomy and gastric bypass without any comorbidity restriction. Previous studies had a retrospective design, except for a recently conducted randomized controlled study [No mortality was encountered, although the group size was small in this matter. Nevertheless, in review the mortality rates of outpatient post-bariatric patients did not differ statistically from patients hospitalized overnight, with the exception of Inaba and Morton et al [No significant differences were found for readmission and reoperation. One patient was readmitted within the same-day discharge period because of collapse and abnormal trend analyses found at teleconsultation on postoperative day one. Two patients undergoing outpatient care required readmission on postoperative day two due to postoperative bleeding. As no abnormalities were revealed from teleconsultation and vitals on postoperative day one, they did not seem to be related to the same-day discharge pathway. Even an hypothesis of more straining at home was considered unlikely as a tachycardia was expected to occur within 8–24 hours of surgery [The current study showed a halved length of stay in the RM group, not excluding any patient groups and taking patient preference into account. Recently, Nijland et al. were the first to conduct a prospective study combining same-day discharge with remote monitoring. A success rate of 88 percent was achieved, which was higher than in our cohort. The authors noted that specific preparation in the preoperative pathway was a positive factor contributing to this success [