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Feasibility assessment of outpatient colorectal resections at a tertiary referral center

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Enhanced Recovery After Surgery (ERAS) protocols, particularly when paired with advanced laparoscopy, have reduced recovery time following colorectal procedures. The aim of this study was to determine if length of stay (LOS) could be reduced to an overnight observation stay (< 24 h) with comparable perioperative morbidity. The secondary aim was to establish predictive factors contributing to early discharge.

Methods

This is a retrospective cohort study of all colectomies at a tertiary care center between January 2016 and January 2019. Inclusion criteria included all colorectal resections with varying surgical approaches. Patients underwent a standardized ERAS protocol. A logistical regression model was conducted for predictive factors.

Results

Three hundred sixty patients were included (55.3% female). Of these, 78 (21.7%) patients were discharged within < 24 h and 112 (31.1%) were discharged within 24–48 h. The remainder comprised the > 48 h group. Age differed significantly between the < 24 h and 24–48 h groups (p < 0.0001). Patients discharged within 24 h were younger (59.4 ± 12.3 years), had a lower CCI score (3.1; p = 0.0026), and lower ASA class (p < 0.0001). Emergency department visits (p = 0.3329) and readmissions (p = 0.6453) prior to POD 30 remained comparable among all groups. Younger age, low ASA, and minimally invasive surgical approach all contributed to ultra-fast discharge.

Conclusion

ERAS protocols may allow for discharge within 24 h following a major colorectal resection, all with low perioperative morbidity and mortality. The predictive factors for discharge within 24 h include a low ASA (I or II), and a minimally invasive surgical approach.

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Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, 1550 N. Northwest Highway, Suite 107, Park Ridge, IL, 60068, USA

    Adam Studniarek, Daniel J. Borsuk, Kunal Kochar, John J. Park & Slawomir J. Marecik

  2. Division of Colon and Rectal Surgery, University of Illinois at Chicago, Chicago, IL, USA

    Kunal Kochar & Slawomir J. Marecik

Authors
  1. Adam Studniarek
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  2. Daniel J. Borsuk
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  3. Kunal Kochar
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  4. John J. Park
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  5. Slawomir J. Marecik
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Contributions

Dr. Adam Studniarek was responsible for manuscript writing, data accrual, and analysis. Daniel Borsuk was responsible for data accrual, analysis, and manuscript writing. Dr. Kunal Kochar was responsible for manuscript revision, data provision, and supervision of the project. Dr. John Park was responsible for the manuscript revision, data provision, and senior supervisor. Dr. Slawomir Marecik was responsible for manuscript writing, data analysis and interpretation, and senior author supervision of the project.

Corresponding author

Correspondence to Slawomir J. Marecik.

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The authors declare that they have no conflict of interest.

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Ethics approval

The study was approved by Advocate Lutheran General Hospital IRB Committee.

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Meeting presentation: SP115 E-Poster, October 28th, 2019, ACS Clinical Congress, San Francisco, CA, USA

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Studniarek, A., Borsuk, D.J., Kochar, K. et al. Feasibility assessment of outpatient colorectal resections at a tertiary referral center. Int J Colorectal Dis 36, 501–508 (2021). https://doi.org/10.1007/s00384-020-03782-w

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  • DOI: https://doi.org/10.1007/s00384-020-03782-w

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