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Background: Although enhanced recovery after bariatric surgery (ERABS) has proven to be safe and cost-effective, this concept is relatively new in the Middle East. Methods: A retrospective analysis of consecutive registered cohorts of patients who underwent primary and purely laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) were compared before introduction of ERABS (2010–2014) and after ERABS (2015–2017) at Tawam Hospital/Johns Hopkins, the UAE. Results: A total of 462 eligible bariatric patients (LSG 414 and LRYGB 48) were operated on before and 1602 (LSG 1436 and LRYGB 166) after introduction of the ERABS. Significant improvements of mean patient time of the patient being within the OR for LSG (from 2:27 to 1:23 min, p = 0.000) and LRYGB (from 3:17 to 1:59 min, p = 0.000) were achieved when comparing pre-ERABS with after introduction of ERABS. Furthermore, there was a significant decrease in LOS in both LSG (from 3.2 to 1.5 days, p = 0.000) and in LRYGB (from 3.5 to 1.7 days, p = 0.000). Major (CD classification III–IV) complications decreased significantly in LSG (from 13.8 to 0.8%, p = 0.000) and were similar in LRYGB (from 4.2% to 3.0%, p = NS). The readmission rate for LSG (from 2.9 to 2.6%, p = NS) or LRYGB (from 0 to 4.8%, p = NS) and the reoperation rates after LSG (from 0.7 to 0.5%, p = NS) and LRYGB (from 0 to 2.4%, p = NS) did not differ between both groups following introduction of ERABS. Conclusions: Implementation of a standardized ERABS program in the Middle East is feasible and safe and leads to reduced LOS and OR times. [ABSTRACT FROM AUTHOR]

Simple Summary: Laparoscopic Sleeve Gastrectomy (LSG) is one of the most effective type of bariatric surgery for weight loss that enables reduction in the size of stomach and associated comorbidities arises from obesity. LSG is well-accepted and safe surgical procedure, but it may lead to malabsorption of nutrients. However, long-term impact of LSG on other risk factors, including blood lipid and fatty acid (FA) profiles, largely remains unknown. The present study aimed to investigate the lipid and plasma FA profiles in patients who underwent LSG in reference to control group with obesity. We determine the markers of inflammation and metabolic risk in these groups by measuring different saturated, monounsaturated, polyunsaturated, and medium-chain FAs. We also estimated the activity of enzymes involved in synthesis of endogenous FA using the product precursor ratios of individual FAs as markers of global metabolic risk. Our study findings showed that patient's 3-yrs post LSG developed a favorable lipid profile than control with similar metabolic profile in both groups, as determined by the blood FA profile and FA ratios. Our findings showed that LSG offers extended positive effect on the lipid profile in obese population. Though, lifestyle interventions following strict regular follow-up to maintain general health and well-being. Visceral obesity is common in the United Arab Emirates and worldwide. Although laparoscopic sleeve gastrectomy (LSG) leads to effective and sustainable weight loss, its long-term beneficial impact on other risk factors, including blood lipid and fatty acid (FA) profiles, remains unknown. These two profiles were assessed in patients 3 years after undergoing LSG and in LSG candidates (controls). Lipid profiles were measured using the Cobas e411 modular analyzer, and 35 FAs were identified. The age and body mass index were 36.55 ± 8.65 years and 31.49 ± 6.43 kg/m2 in the LSG group and 35.44 ± 9.51 years and 32.29 ± 5.38 kg/m2 in the control group, respectively. The overall lipid profile was more favorable in the LSG group than in the control group. Total saturated, monounsaturated, and polyunsaturated FAs were similar between the groups, but total medium-chain FAs were more abundant in the LSG group. In endogenous FA synthesis, the estimated activity of C16Δ9 desaturase and Δ5 desaturase decreased, whereas that of elongase increased in the LSG group compared with that in the control group. The benefits of LSG on blood lipid and FA profiles in patients with 3-year LSG may be limited. Hence, lifestyle interventions combined with a long-term and strict regular follow-up regime may be warranted for patients undergoing LSG. [ABSTRACT FROM AUTHOR]