Beyond enhanced recovery after surgery (ERAS): Evolving minimally invasive colectomy from multi-day admissions to same-day discharge - 02/05/23
, Karleigh R. Curfman b , Gabrielle E. Blair b , Chirag A. Shah c , Laila Rashidi b Abstract |
Introduction |
Early discharge is increasingly important in the resource-limited COVID era. Some groups have reported early experiences with same day discharge (SDD) after colectomy. We implemented a routine SDD protocol and report the evolution in our program's outcomes.
Methods |
We studied a retrospective cohort of robotic colorectal surgeries from 2016 to 2022. Colectomies were analyzed as a sub-group and stratified by year.
Results |
The cohort comprised 535 cases, of which 483 were colectomies. Annual case volume increased from 58 to 180 cases (p < 0.001). Operative console time concordantly decreased by 33% (p < 0.001). Average length of stay decreased from five to one days. By 2022, 58% of colectomies were selectively discharged on the same day of surgery. Complication and readmission rates remained constant.
Conclusions |
SDD is feasible and safe in selected patients. We illustrate the practical evolution of a surgical practice toward routine SDD, and discuss the factors we found critical to this transition.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Despite advances of ERAS, colectomy still usually demands 1–2 day inpatient stay. |
• | Early, limited data exists on same-day-discharge (SDD) after colectomy. |
• | We analyze longitudinal outcomes after starting routine SDD during the era. |
• | In the last year, over half of patients underwent SDD successfully. |
• | Multi-disciplinary pathways and advanced robotic surgical techniques were crucial. |
Keywords : Robotic colectomy, ERAS, Ambulatory, Same day
Plan
Vol 225 - N° 5
P. 826-831 - mai 2023 Retour au numéro
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