The patient perspective of same day discharge colectomy: one hundred patients surveyed on their experience following colon surgery

Curfman, Karleigh R.; Blair, Gabrielle E.; Pille, Sunshine A.; Kosnik, Callan L.; Rashidi, Laila

doi:10.1007/s00464-022-09446-w

Cited by 12 publications

(18 citation statements)

References 14 publications

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“…These will be instrumental for a wider adoption of ALC even though, according to the study specifically reporting on this, ALC was well received by patients, with 87% acceptance rate [6]. Furthermore, ALC seems to achieve high patient satisfaction, with up to 100% satisfaction rate and 80%–85% of patients convinced to make the same choice again [5, 44].…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

Ambulatory laparoscopic colectomies: a systematic review

et al. 2023

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“…When considering same-day discharge for colectomies, it is important to know if early discharge is associated with increased ED visits and readmissions due to complications like ileus or anastomotic gastrointestinal hemorrhage occurring after discharge, complications that may have been prevented by a longer hospital stay. [1][2][3][4][5] Enhanced recovery pathways have decreased complications and allowed earlier discharge, but ileus can be an unpredictable complication even after uneventful operations. 9 The number of same-day discharge patients in this study may be underpowered to draw firm conclusions.…”

Section: Discussionmentioning

confidence: 99%

“…1 Robotic colectomy patients are now frequently discharged on postoperative day 1 or 2 and this has led to reports suggesting feasibility of same-day discharge. [2][3][4][5][6][7] Discharge on the same day after surgery has not yet been widely adopted and the benefit when compared to an overnight hospital stay is still under investigation. 3,4 Same-day discharge requires a different admission pathway that may impact hospital reimbursement.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4][5][6][7] Discharge on the same day after surgery has not yet been widely adopted and the benefit when compared to an overnight hospital stay is still under investigation. 3,4 Same-day discharge requires a different admission pathway that may impact hospital reimbursement. 2,3 When considering same-day discharge, it would be important to know if early discharge is associated with increased emergency department (ED) visits and readmissions, and delay in identifying complications that warrant reintervention resulting in worse outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Same-day discharge requires a different admission pathway that may impact hospital reimbursement. 2,3 When considering same-day discharge, it would be important to know if early discharge is associated with increased emergency department (ED) visits and readmissions, and delay in identifying complications that warrant reintervention resulting in worse outcomes. 4 The aim of this study is to determine if discharge on postoperative days one (POD-1) or two (POD-2) after elective colectomy for benign and malignant disease is associated with increased rates of ED visits and hospital readmissions after discharge.…”

Section: Introductionmentioning

confidence: 99%

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Early Discharge after Enhanced Recovery Colectomy Does Not Increase Emergency Department Visits and Readmissions: A Single Institution Analysis

Baur,

Sood,

Huebner

et al. 2024

The American Surgeon™

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Background Same-day discharge after colorectal surgery in enhanced recovery pathways is increasing. This study aimed to determine if discharge on postoperative days (POD) one or two is associated with increased rates of emergency department (ED) visits and hospital readmissions after left and right colectomy. Methods Single institution retrospective analysis of prospective institutional colorectal surgery database between 07/01/2018 and 07/15/2022. Primary outcomes were ED visit and readmission rates for enhanced recovery open and minimally invasive right and left colectomy using logistic regressions models. Results 820 patients met inclusion criteria. There were significant differences in discharge-day by diagnosis—58.5% of patients with Crohn’s disease were discharged on POD ≥4 and 21.6% with benign colon neoplasia were discharged on POD-0-1 ( P < .001). ED visits occurred in 12.9% of the study population and were not significantly different between discharge-day groups ( P = .096). Overall readmission rate was 8.5% and significantly different between discharge-day groups (0% POD-0 vs 8.3% POD-1 vs 5.8% POD-2 vs 6.9% POD-3 vs 12.9% POD ≥4, P = .041). Logistic regression showed that ED visits and readmissions for longer discharge-days (POD-2, POD-3, POD ≥4) were not significantly different than POD-0-1. Readmission diagnoses for the study population were higher for ileus (17.1%) and surgical site infection (SSI) type-III (22.9%) than for acute kidney injury (1.4%) and SSI type-I/II (1.4%). Conclusion Early discharge after left and right colectomy is not associated with increased rates of ED visits and readmissions. Same-day discharge may be feasible in selected enhanced recovery patients. Standardized post-discharge resources that safely allow same-day discharge require further investigation.

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Same-day discharge (SDD) vs standard enhanced recovery after surgery (ERAS) protocols for major colorectal surgery: a systematic review

Zheng

Wee

Abdullah

et al. 2023

Int J Colorectal Dis

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Background Enhanced recovery after surgery (ERAS) programs are well-established, resulting in improved outcomes and shorter length of hospital stay (LOS). Same-day discharge (SDD), or “hyper-ERAS”, is a natural progression of ERAS. This systematic review aims to compare the safety and efficacy of SDD against conventional ERAS in colorectal surgery. Methods The protocol was prospectively registered in PROSPERO (394793). A systematic search was performed in major databases to identify relevant articles, and a narrative systematic review was performed. Primary outcomes were readmission rates and length of hospital stay (LOS). Secondary outcomes were operative time and blood loss, postoperative pain, morbidity, nausea or vomiting, and patient satisfaction. Risks of bias was assessed using the ROBINS-I tool. Results Thirteen studies were included, with five single-arm and eight comparative studies, of which one was a randomised controlled trial. This comprised a total of 38,854 patients (SDD: 1622; ERAS: 37,232). Of the 1622 patients on the SDD pathway, 1590 patients (98%) were successfully discharged within 24 h of surgery. While most studies had an overall low risk of bias, there was considerable variability in inclusion criteria, types of surgery or anaesthesia, and discharge criteria. SDD resulted in a significantly reduced postoperative LOS, without increasing risk of 30-day readmission. Intraoperative blood loss and postoperative morbidity rates were comparable between both groups. Operative duration was shorter in the SDD group. Patient-reported satisfaction was high in the SDD cohort. Conclusion SDD protocols appear to be safe and feasible in selected patients undergoing major colorectal operations. Randomised controlled trials are necessary to further substantiate these findings.

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The patient perspective of same day discharge colectomy: one hundred patients surveyed on their experience following colon surgery

Cited by 12 publications

References 14 publications

Ambulatory laparoscopic colectomies: a systematic review

Ambulatory laparoscopic colectomies: a systematic review

Early Discharge after Enhanced Recovery Colectomy Does Not Increase Emergency Department Visits and Readmissions: A Single Institution Analysis

Same-day discharge (SDD) vs standard enhanced recovery after surgery (ERAS) protocols for major colorectal surgery: a systematic review

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