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. 2025 Mar;39(3):1848-1857.
doi: 10.1007/s00464-024-11454-x. Epub 2025 Jan 21.

Feasibility of an < 24 h discharge pathway with tele-monitoring after elective colectomies: a pilot study

B P Smalbroek  1   2 , L M Dijksman  3 , F B Poelmann  4 , H C van Santvoort  5 , T Weijs  6 , N A T Wijffels  5 , A B Smits  5
Affiliations

Feasibility of an < 24 h discharge pathway with tele-monitoring after elective colectomies: a pilot study

B P Smalbroek et al. Surg Endosc. 2025 Mar.

Abstract

Introduction: Implementation of enhanced recovery after surgery principles has led to exploration of ambulatory pathways in surgery, including gastrointestinal surgery. However, implementation of ambulatory pathways after colorectal surgery has not been established yet. Previous studies suggest that discharge within 24 h in colorectal surgery is only possible with a clear protocol and careful patient selection.

Methods: Single center prospective feasibility pilot study of thirty patients in one large non-academic teaching hospital in the Netherlands. Patients were included if they were between 18 and 80 years old, underwent elective minimal invasive colonic resection with anastomosis, had a ASA-score of I or II, fully understood the procedure, had a person at home the first 4 days after surgery and lived within 30 min travel radius to the hospital. Exclusion criteria were cT4 tumours, multi-visceral resections, insulin-dependent diabetes, anti-coagulants which required perioperative bridging, and perioperative complications. Patients followed a pathway with discharge within 24 h postoperatively and were monitored by a tele-monitoring smartphone application after discharge.

Results: Thirty patients were included and twenty-one patients (70%) fulfilled discharge criteria within 24 h after surgery. Six (20%) patients were readmitted within 30 days. Complications occurred in six (20%) patients, which was classified as Clavien-Dindo ≥ 3 complication in one (3%) patient. Patients and health care provider satisfaction was high.

Conclusion: Findings of this study support the feasibility and safety of an early discharge protocol with tele-monitoring after minimal invasive colonic resection. Satisfaction of patients and health care providers was high.

Keywords: Colectomies; Early discharge; Surgery; Telemonitoring.

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Conflict of interest statement

Declarations. Disclosures: Dr. A.B. Smits has a position as an independent contractor as a robotic surgeon proctor and has been a invited speaker at Intuitive surgical Inc. and Bo P Smalbroek MD has been currently receiving a grant from Intuitive Surgical Inc. on another study. Dr. Floris Poelmann, Lea Dijksman, Niels Wijffels. Teus Weijs and Prof Dr. Hjalmar van Santvoort have no financial ties to disclose. No preregistration exists for the reported studies reported in this article.

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