Ambulatory laparoscopic colectomies: a systematic review

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Patient Outcomes

Background:

• Ambulatory laparoscopic colectomy (ALC), defined as discharge within 24 hours of colonic resection, is a novel approach for select patients.
• This systematic review evaluates the feasibility, safety, and outcomes of ALC based on existing literature.

Approach:

• A PRISMA-compliant systematic review and pooled analysis of English-language studies published up to October 2022.
• Inclusion criteria focused on original articles detailing ALC outcomes, excluding robotic procedures and duplicate patient series.
• Primary outcomes assessed were success rates, overall complications, and readmissions, with secondary outcomes including mortality and specific adverse events.

Key Points:

• The review included 11 studies encompassing 1296 patients undergoing ALC.
• Achieved an overall success rate of 47% with 14% overall morbidity.
• Reported a 5% readmission rate, 1% reoperation rate, and no mortality.

Conclusions:

• Ambulatory laparoscopic colectomy (ALC) demonstrates safety and feasibility in carefully selected patients.
• The current protocols for ALC vary significantly, highlighting a need for standardization.
• Future research should focus on patient benefits, discharge criteria, and uniform eligibility for ALC adoption.