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.
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.
Keywords
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Article info
Publication history
Published online: January 21, 2023
Accepted:
January 20,
2023
Received in revised form:
December 27,
2022
Received:
November 9,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
