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CC BY-NC-ND 4.0 · Journal of Coloproctology 2023; 43(03): e235-e242
DOI: 10.1055/s-0043-1773783
Review Article

Twenty-four Hours Stay After Colorectal Surgery; A Systematic Review

Authors

  • Bo P. Smalbroek 

    1   Department of Surgery, St. Antonius, Utrecht, the Netherlands
    2   Department of Valued Based Healthcare, St. Antonius, Utrecht the Netherlands

  • Inger-Lise Schuffel

    1   Department of Surgery, St. Antonius, Utrecht, the Netherlands

  • Teus J. Weijs

    1   Department of Surgery, St. Antonius, Utrecht, the Netherlands

  • Lea M. Dijksman

    2   Department of Valued Based Healthcare, St. Antonius, Utrecht the Netherlands

  • Floris B. Poelmann

    1   Department of Surgery, St. Antonius, Utrecht, the Netherlands

  • Niels A.T. Wijffels

    1   Department of Surgery, St. Antonius, Utrecht, the Netherlands

  • Djamila Boerma

    1   Department of Surgery, St. Antonius, Utrecht, the Netherlands

  • Anke B. Smits

    1   Department of Surgery, St. Antonius, Utrecht, the Netherlands

Funding There was no funding involved in this study. Sponsor of this study is the department of Surgery in Antonius hospital, Nieuwegein, the Netherlands.
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Abstract

Introduction The introduction of Enhanced Recovery After Surgery led to increasing twenty-four hours discharge pathways, for example in laparoscopic cholecystectomy and bariatric surgery. However, implementation in colorectal surgery still must set off. This systematic review assesses safety and feasibility of twenty-four hours discharge in colorectal surgery in terms of readmission and complications in current literature. Secondary outcome was identification of factors associated with success of twenty-four hours discharge.

Methods Pubmed and EMBASE databases were searched to identify studies investigating twenty-four hours discharge in colorectal surgery, without restriction of study type. Search strategy included keywords relating to ambulatory management and colorectal surgery. Studies were scored according to MINORS score.

Results Thirteen studies were included in this systematic review, consisting of six prospective and seven retrospective studies. Number of participants of the included prospective studies ranged from 5 to 157. Median success of discharge was 96% in the twenty-four hours discharge group. All prospective studies showed similar readmission and complication rates between twenty-four hours discharge and conventional postoperative management. Factors associated with success of twenty-four hours discharge were low ASA classification, younger age, minimally invasive approach, and relatively shorter operation time.

Conclusions Twenty-four hours discharge in colorectal surgery seems feasible and safe, based on retro- and prospective studies. Careful selection of patients and establishment of a clear and adequate protocol are key items to assure safety and feasibility. Results should be interpreted with caution, due to heterogeneity. To confirm results, an adequately powered prospective randomized study is needed.

Keywords

ERAS - ambulatory - 24 hours discharge - twenty-four hours stay - hospitalization - colorectal

Authors' Contributions

Substantial contributions to the conception and design of the work: Smalbroek, Schuffel, Weijs, Smits


Drafting the article: Smalbroek. Schuffel


Revising the article critically for important intellectual content: Weijs, Dijksman, Poelmann,, Boerma, Smits


Final approval of the version to be published: Smalbroek, Schuffel, Weijs, Dijksman, Poelmann, Wijffels, Smits


All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


Availability of Data

All data used is present in this article or supplementary material.


Supplementary Material



Publikationsverlauf

Eingereicht: 04. Juli 2023

Angenommen: 14. August 2023

Artikel online veröffentlicht:
21. September 2023

© 2023. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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