Discharge criteria after colon resection: Is return of bowel function necessary?

Abstract

Background: This study was performed to evaluate tolerance of liquids as discharge criteria in a perioperative enhanced recovery protocol.

Methods: Patients undergoing elective colon resections were prospectively enrolled in a standardized perioperative enhanced recovery process. Patients were eligible for discharge when able to tolerate sufficient oral liquids, as determined by clinical means, that intravenous fluids were no longer needed.

Results: Over an 18 month period, 94 patients were evaluated; 75 (80%) tolerated sufficient liquids such that intravenous fluids were no longer needed by the second and all by the third postoperative day. The average postoperative length of stay was 3.8 days. At discharge, 59 (63%) and 20 (21%) patients reported passage of flatus and stool respectively. On 30 day follow up, 8 (8.5%) patients had been re-admitted.

Conclusion: These data suggest that after elective colon surgery, patients can be discharged when able to tolerate sufficient oral liquids.

Keywords: Colectomy; Enhanced recovery after surgery; Enhanced recovery protocol; Perioperative care.