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Observational Study
. 2023 Mar;127(3):434-440.
doi: 10.1002/jso.27130. Epub 2022 Oct 26.

Ambulatory colectomy for cancer: Results from a prospective bicentric study of 177 patients

Héloïse Seux  1 , Benoît Gignoux  2 , Marie-Cécile Blanchet  2 , Vincent Frering  2 , Régis Fara  1 , Antoine Malbec  1 , Benjamin Darnis  2 , Antoine Camerlo  1
Affiliations
Observational Study

Ambulatory colectomy for cancer: Results from a prospective bicentric study of 177 patients

Héloïse Seux et al. J Surg Oncol. 2023 Mar.

Abstract

Background: The implementation of an Enhanced Recovery After Surgery programme after colectomy reduces postoperative morbidity and shortens the length of hospital stay.

Objective: To evaluate the short and midterm outcomes of ambulatory colectomy for cancer.

Methods: This was a two-centre, observational study of a database maintained prospectively between 2013 and 2021. Short-term outcome measures were complications, admissions, unplanned consultations and readmission rates. Midterm outcome measures were the delay between surgery and initiation of adjuvant chemotherapy, length of disease-free survival and 2-year disease-free survival rate.

Results: A total of 177 patients were included. The overall morbidity rate was 15% and the mortality rate was 0%. The admission rate was 13% and 11% patients left hospital within 24 h of surgery. The readmission rate was 9% and all readmissions occurred before postoperative Day 4. Eight patients underwent repeat surgery because of anastomotic fistula (n = 7) or anastomotic ileocolic bleeding (n = 1). These patients had an uneventful recovery. Sixty-one patients required adjuvant chemotherapy with a median delay between surgery and chemotherapy initiation of 35 days.

Conclusions: Ambulatory colectomy for cancer is feasible and safe. Adjuvant chemotherapy could be initiated before 6 weeks postsurgery. The ambulatory approach may be a step forward to further improve morbidity and oncologic prognosis.

Keywords: ambulatory surgery; colectomy; colon cancer; colorectal surgery; outpatient.

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References

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