eP130 - Same Day Colectomy: Bringing Tomorrow Home

Purpose/Background: Historically, patients undergoing elective colectomy experienced extended hospital stays. The introduction of the Enhanced Recovery After Surgery (ERAS) protocol in 2005 has led to notable improvement in surgical outcomes and reductions in postoperative stay. This advancement has laid the groundwork for Same-Day Colectomies (SDC). Several Tertiary centers have explored the feasibility of this approach, yielding varying degrees of success; however, feasibility in the community setting has yet to be studied. This study assesses the viability of implementing SDC within the community healthcare context.Methods/Interventions: An ongoing cohort study commenced in September 2022 to evaluate the potential for same-day discharge following minimally invasive elective colectomy. Rigorous screening criteria are employed to evaluate patient eligibility. An institutionally tailored ERAS protocol is followed throughout the preoperative, intraoperative, and postoperative phases. After discharge, monitoring is conducted via telephone checkups. The primary outcome is the occurrence of readmission within 7 days, while secondary outcomes encompass postoperative functional status, restoration of bowel function, and the incidence of complications such as surgical site infections, anastomotic leaks, and urinary infections.Results/Outcomes: In the present study phase, 7 eligible participants were enrolled. Of these, 3 patients underwent successful right hemicolectomy and were discharged on the same day as the surgery. Additionally, 3 patients (2 with sigmoidectomy and 1 with right hemicolectomy) were discharged on the first postoperative day. Moreover, 1 patient with left hemicolectomy was discharged on the second day after surgery. On average, patients not discharged on the same day underwent longer operation time (mean: 1.67 hours vs. 2.75 hours, P = 0.19). No instances of complications or readmissions were observed following discharge. All surgical procedures were conducted using minimally invasive Robotic-assisted techniques. Admissions were primarily due to lengthy operations (2 patients) and reduced postoperative mobility (2 patients).Conclusion/

Discussion: While the study remains ongoing, initial findings affirm the secure and systematic integration of the SDC approach within the community healthcare framework by showcasing the absence of complications or readmissions. This success rests upon pivotal factors, including thorough preoperative patient education, effective interdisciplinary collaboration, and vigilant post-discharge monitoring. Looking forward, our objective is to expand the scope of our approach. This expansion will involve refining the selection criteria, leveraging postoperative monitoring applications, and transitioning from a predominantly right colectomy focus to encompass a broader range of procedures, such as left colectomies, sigmoid resections, and potentially protectomies. These strategic steps will contribute significantly to the establishment of optimal indications for the implementation of the SDC approach.PatientsThe table shows patient demographics, surgical indications, procedure details, post-operative recovery milestones, and medication needs.