Highlights
- •Ambulatory Colectomy is safe and reproducible in select patients.
- •Preoperative education and understanding of the procedure are reviewed and confirmed through patient teach back methods.
- •Patient, physician, and support team communication is vital to success.
- •Strict inclusion and exclusion criteria are necessary to ensure patient safety.
Abstract
Background
Since its inception colectomy has routinely been performed in the inpatient setting.
The advent of Enhanced Recovery After Surgery (ERAS) protocols has led improved outcomes,
including decreased length of stay (LOS). These improvements have introduced the possibility
of ambulatory colectomy. However, indications, protocols, and limitations of ambulatory
colectomy have not been extensively explored.
Methods
We conducted a retrospective review on ambulatory colectomies performed between February
2019 and August 2021. Patients were candidates for same day discharge (SDD) if they
met rigorous preoperative criteria. Following an uncomplicated operation, strict postoperative
parameters were required for safe discharge. If the patient underwent SDD following
their operation, they were monitored closely via telehealth visits and/or patient
communication messages until their one-week postoperative visit.
Results
From our review, we identified sixty-nine (n = 69) patients who underwent SDD after
colectomy. Of the 69, only one patient was readmitted after discharge (1.4%). All
procedures were performed via a robotic-assisted approach (Da Vinci Xi). None of the
patients underwent conversion to an open procedure. The most frequently performed
procedures included: low anterior resection (LAR) (n = 32, 46.4%) and right hemicolectomy
(n = 11, 15.9%).
Conclusion
Through proper patient education and strictly defined communication between the patient
care teams, safe and effective care in the setting of SDD after colectomy can be provided.
With recent technological advancements, enhanced mechanisms for patient education
throughout all phases, and emerging means of patient-physician communication, via
the data included herein the opportunity for same day discharge (SDD) after colectomy
is a feasible and safe management plan in the proper patient.
Keywords
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Article info
Publication history
Published online: May 10, 2022
Accepted:
April 30,
2022
Received in revised form:
April 11,
2022
Received:
November 15,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
