Eligibility criteria for ambulatory colectomy

Area of Science:

• Colorectal Surgery
• Surgical Outcomes
• Patient Eligibility Criteria

Background:

• Ambulatory colectomy offers potential benefits but requires careful patient selection.
• Identifying predictors for successful ambulatory colectomy is crucial for optimizing surgical practice.

Purpose of the Study:

• To establish statistical indicators for identifying suitable patients for ambulatory colectomy.
• To define criteria for proposing ambulatory colectomy without increasing patient risk.

Main Methods:

• Retrospective review of 110 patients undergoing colectomy between 2018-2019.
• Eligibility defined by hospital stay ≤4 days and no postoperative complications.
• Multivariate analysis and decision-tree modeling to identify independent predictors.

Main Results:

• Age (≥65 years), diabetes, and surgical indication were key independent variables.
• High eligibility likelihood for younger patients with diverticulosis and ERAS protocol (92-96.9%).
• Low eligibility for diabetic patients ≥65 years (8.3% without ERAS, 10-20.1% with ERAS).

Conclusions:

• Sigmoidectomy for diverticulosis in patients <65 years is the optimal indication for ambulatory colectomy.
• Ambulatory colectomy is not recommended for diabetic patients ≥65 years.
• Other patient groups may be eligible with satisfactory application of the enhanced recovery after surgery (ERAS) protocol.