title: Early Postoperative Progression to Solid Foods Is Safe After Roux-en-Y Gastric Bypass.
abstract: BACKGROUND
  Even though admission time is reduced with the implementation of various enhanced recovery protocols, many clinics still instruct patients after weight loss surgery to maintain a fluid or minced-food diet for at least 2 weeks postoperatively. We reasoned that with adequate preoperative instructions, including adequate chewing of all foods, early progression to solid foods would not increase the risk of (gastro)enterostomy leakage.
  
  
  METHODS
  In December 2010, a new dietary protocol was implemented for all patients undergoing a Roux-en-Y gastric bypass, allowing progression to solid foods from 12 h postprocedure onwards. All patients received thorough preoperative eating instructions and eating awareness counselling from a qualified dietician and psychologist. A retrospective study was performed of 936 patients who underwent a primary or redo laparoscopic Roux-en-Y gastric bypass between January 2011 and June 2014 in our hospital. All 30-day complications, readmissions and reoperations were noted.
  
  
  RESULTS
  No 30-day loss to follow-up occurred. Overall 30-day complication rate was 9.4%, with gastrointestinal leakage occurring in only 0.6%. A low threshold for readmission was maintained due to the short mean admission time of 1.87 days. Readmission rate was 4.8%--mainly for observation of postoperative pain--and 1.8% of our patients required reoperation within 30 days. Mortality was 0.1%. Our results are comparable to results published by other Dutch centres advocating conventional diets, showing no increase in leakage or other complications.
  
  
  CONCLUSIONS
  We conclude that early progression to solid foods after Roux-en-Y gastric bypass surgery is a feasible alternative as no increase in complications is observed.
authors.affiliation: Department of Surgery, Elisabeth-TweeSteden Hospital, Dr. Deelenlaan 5, 5042 AD, Tilburg, Netherlands. ctheunissen@tsz.nl.
authors.forename: Caroline M J
authors.initials: CM
authors.lastname: Theunissen
authors.affiliation: Department of Surgery, Elisabeth-TweeSteden Hospital, Dr. Deelenlaan 5, 5042 AD, Tilburg, Netherlands.
authors.forename: John K
authors.initials: JK
authors.lastname: Maring
authors.affiliation: Department of Nutrition, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands.
authors.forename: Natascha J C
authors.initials: NJ
authors.lastname: Raeijmaekers
authors.affiliation: Department of Surgery, Elisabeth-TweeSteden Hospital, Dr. Deelenlaan 5, 5042 AD, Tilburg, Netherlands.
authors.forename: Ingrid S
authors.initials: IS
authors.lastname: Martijnse
authors.affiliation: Department of Surgery, Elisabeth-TweeSteden Hospital, Dr. Deelenlaan 5, 5042 AD, Tilburg, Netherlands.
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Langenhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control; D004435:Eating; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000534:rehabilitation; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000178:diet therapy / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D055815:Young Adult
keywords: Complications; Diet; ERABS; Enhanced recovery; Gastric bypass; Postoperative; Solid foods