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Same-Day Discharge After Minimally Invasive Colectomy

To identify the key insights or developments described in this article
1 Credit CME

Enhanced recovery pathways (ERP) for colorectal surgery have become standard of care for perioperative management but can be further improved.1 Same-day discharge (SDD) programs represent the evolution of current ERP practices to allow for discharge on the day of surgery after minimally invasive surgery (MIS) colectomy. Pathways for SDD focus on minimizing or improving the aspects of care that keep a patient hospitalized, that is, (1) discharge before recovery of gastrointestinal function, (2) improvements in multimodal analgesia, and (3) effective postdischarge remote follow-up.2 These elements act synergistically within a comprehensive program that is built on standard ERP practices to further minimize surgical stress and improve immediate postoperative recovery to the point of allowing for SDD in select patients undergoing MIS colectomy (Box).

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Lawrence Lee, MD, PhD, McGill University Health Centre, 1001 Boulevard Decarie DS1-3310, Montreal, QC H4A 3J1, Canada (larry.lee@mcgill.ca).

Published Online: September 28, 2022. doi:10.1001/jamasurg.2022.4123

Conflict of Interest Disclosures: Dr Lee reported grants from Johnson & Johnson and personal fees from Stryker. Dr Rashidi reported personal fees from Intuitive Surgical. No other disclosures were reported.

References
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2.
Lee  L , Eustache  J , Baldini  G ,  et al.  Enhanced recovery 2.0: same day discharge with mobile app follow-up after minimally invasive colorectal surgery.   Ann Surg. Published online June 2, 2021. doi:10.1097/SLA.0000000000004962PubMedGoogle ScholarCrossref
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Surve  A , Cottam  D , Zaveri  H ,  et al.  Does the future of laparoscopic sleeve gastrectomy lie in the outpatient surgery center? a retrospective study of the safety of 3162 outpatient sleeve gastrectomies.   Surg Obes Relat Dis. 2018;14(10):1442-1447. doi:10.1016/j.soard.2018.05.027PubMedGoogle ScholarCrossref
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Gignoux  B , Gosgnach  M , Lanz  T ,  et al.  Short-term outcomes of ambulatory colectomy for 157 consecutive patients.   Ann Surg. 2019;270(2):317-321. doi:10.1097/SLA.0000000000002800PubMedGoogle ScholarCrossref
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Lee  L , Eustache  J , Tran-McCaslin  M ,  et al.  North American multicentre evaluation of a same-day discharge protocol for minimally invasive colorectal surgery using mHealth or telephone remote post-discharge monitoring.   Surg Endosc. 2022. doi:10.1007/s00464-022-09208-8PubMedGoogle ScholarCrossref
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Eustache  J , Latimer  EA , Liberman  S ,  et al.  A mobile phone app improves patient-physician communication and reduces emergency department visits after colorectal surgery.   Dis Colon Rectum. Published online December 20, 2021. doi:10.1097/DCR.0000000000002187PubMedGoogle ScholarCrossref
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ESCP Enhanced Recovery Collaborating Group.  An international assessment of the adoption of enhanced recovery after surgery (ERAS®) principles across colorectal units in 2019-2020.   Colorectal Dis. 2021;23(11):2980-2987. doi:10.1111/codi.15863PubMedGoogle ScholarCrossref
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