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. 2023 May;225(5):826-831.
doi: 10.1016/j.amjsurg.2023.01.024. Epub 2023 Jan 21.

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

Michael M Vu  1 , Karleigh R Curfman  2 , Gabrielle E Blair  3 , Chirag A Shah  4 , Laila Rashidi  5
Affiliations

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

Michael M Vu et al. Am J Surg. 2023 May.

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: Ambulatory; ERAS; Robotic colectomy; Same day.

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Conflict of interest statement

Declaration of competing interest Laila Rashidi, MD is an advisor and speaker for C-SATS© and Inuitive©. The remaining authors have no conflicts of interest to disclose.