Overnight Hospital Stay After Colon Surgery for Adenocarcinoma

Rogers, James P.; Dobradin, Andrew; Kar, Pran M.; Alam, Shaan E.

doi:10.4293/108680812x13427982376789

Cited by 10 publications

(8 citation statements)

References 16 publications

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“…one [5] on postoperative day (POD) 3, one [13] on POD 5, one [15] on POD 7, one [14] on POD 10, one [16] 10 and 21 and two [6,20] 30 days after surgery. Telephonic consultation was used in three studies [5,6,16]: in two studies [5,16] this was done by surgeons, in one [6] by nurses.…”

Section: Discharge Criteria and Outpatient Follow-upmentioning

confidence: 99%

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Ambulatory laparoscopic colectomies: a systematic review

et al. 2023

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Aim Ambulatory laparoscopic colectomy (ALC), meaning discharge within 24 h of surgical colonic resection, has recently been proposed in a few, selected patients. This systematic review was performed with the aim of reviewing protocols for ALC and assessing feasibility, safety and outcomes after ALC. Method A PRISMA‐compliant systematic review and pooled analysis was performed searching all English studies published until October 2022 in PubMed, Cochrane Library, Web of Science (PROSPERO, CRD42022334463). Inclusion criteria were original articles including patients undergoing ALC, specifying at least one outcome of interest. Exclusion criteria were articles reporting a robotic‐assisted procedure; unable to retrieve patient data from articles; the same patient series included in different studies. Primary outcomes were success, overall complications and readmission rates. Secondary outcomes included mortality and specific complications such us surgical site infection, anastomotic leak, ileus, bleeding, rate of ALC acceptance, and unscheduled consultation and reoperation rate. Results Among 1087 studies imported for screening, 11 were included (1296 patients). The success rate was 47% with an overall morbidity of 14%. Readmission and reoperation rates were 5% and 1%, respectively. No mortality was recorded. Protocols of ALC differ significantly among published studies. Conclusions Overall, ALC appears to be safe and feasible in selected cases with an acceptable success rate and a low risk of readmission after hospital discharge. Future studies should evaluate patients' benefits and discharge criteria, as well as uniformity and standardization of eligibility criteria. This systematic review may help inform on ALC adoption in clinical practice.

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Section: Discharge Criteria and Outpatient Follow-upmentioning

confidence: 99%

“…Eleven studies [5,6,[12][13][14][15][16][17][18][19][20] were included in the ALC protocol discussion.…”

Section: Ambulatory Colectomy Protocolsmentioning

confidence: 99%

Ambulatory laparoscopic colectomies: a systematic review

et al. 2023

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“…Meta‐analyses of randomized clinical trials have concluded that laparoscopic cholecystectomy with intraoperative CBD exploration and ERCP have similar rates of stone clearance, morbidity and mortality. However, when laparoscopic cholecystectomy and CBD exploration are used as a single‐stage approach, the procedure is associated with a shorter hospital stay and is likely to be more cost‐effective than ERCP with sequential cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%

Learning curve and outcome of laparoscopic transcystic common bile duct exploration for choledocholithiasis

Zhu

Han

Guo

et al. 2015

British Journal of Surgery

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“…Additionally, our comparison group from 2013 had a better than expected LOS of 4.2 days and 3.69 days for open and MIS approaches, respectively-within the 2-5 day range purported as the benefit of ERAS protocol introduction 4,5 and far below the national average of 7-10 days. 6 It is worth noting some elements of the protocol such as early ambulation, MIS approaches, and early nutrition were already informally being practiced, so it could be we were already attaining the maximal gains from beneficial portions of the protocol prior to standardization.…”

Section: Discussionmentioning

confidence: 64%

Effect of Enhanced Recovery After Surgery Protocol Implementation on Cost and Outcomes by Type of Colectomy Performed

Landry

Lewis

Antill

et al. 2020

The American Surgeon

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Background Enhanced recovery after surgery (ERAS) protocols are widely utilized for elective colorectal surgery to improve outcomes and decrease costs, but few studies have evaluated the impact of ERAS protocols on cost with respect to anatomic site of resection. This study evaluated the impact of ERAS protocol on elective colon resections by site and longitudinal impact over time. Methods A single-center retrospective cohort study of 598 consecutive patients undergoing elective colorectal resection before and after implementation of ERAS protocol from 2013 to 2017 was performed. The primary outcomes were length of stay (LOS) and cost. Comparative and multivariate inferential statistics were used to assess additional outcomes. Results A total of 598 patients (100 pre-ERAS vs 498 post-ERAS) were evaluated with an overall median LOS of 4 days for right and left colectomies and 3 days for transverse colectomies. When comparing type of resection before and after ERAS protocol introduction, an increased LOS for left hemicolectomies from 3.09 to 4.03 days ( P = .047) was noted, with all other comparisons failing to reach statistical significance. Over time, an initial decrease in LOS for MIS approach after protocol introduction was observed; however, this effect diminished in the ensuing years and had no significant effect overall. Total cost of care was significantly increased post-ERAS for all cohorts except transverse colectomies. No further statistically significant differences were found. Conclusion After an initial improvement in outcomes, continued utilization of ERAS protocols demonstrated no improvement in LOS compared to pre-ERAS data and increased cost overall for patients regardless of site of resection.

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Overnight Hospital Stay After Colon Surgery for Adenocarcinoma

Abstract: A fast-track perioperative procedure may achieve the same low-risk, low-morbidity results for laparoscopic colectomy patients as seen with more conventional lengths of hospital stay.

Cited by 10 publications

References 16 publications

Ambulatory laparoscopic colectomies: a systematic review

Ambulatory laparoscopic colectomies: a systematic review

Learning curve and outcome of laparoscopic transcystic common bile duct exploration for choledocholithiasis

Effect of Enhanced Recovery After Surgery Protocol Implementation on Cost and Outcomes by Type of Colectomy Performed

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