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Beyond enhanced recovery after surgery (ERAS): Evolving minimally invasive colectomy from multi-day admissions to same-day discharge

Published:January 21, 2023DOI:


      • 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.



      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.


      We studied a retrospective cohort of robotic colorectal surgeries from 2016 to 2022. Colectomies were analyzed as a sub-group and stratified by year.


      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.


      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.


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