Ambulatory discharge after colorectal resection: How early a discharge after surgery is feasible and safe?

The feasibility and safety of ambulatory (23-h stay) surgery in patients undergoing colorectal resection has been previously demonstrated. The aim of this work was to compare outcomes of patients discharged directly from the postanaesthesia care unit at 6-8 h postsurgery to assess the feasibility of even earlier discharges.

We performed a retrospective observational study of all patients undergoing intestinal resection with primary anastomosis by a single surgeon at an academic centre over a 2-year period. Patients were divided into three groups: an early discharge group (discharged 6-8 h postsurgery), an ambulatory group (discharged at 8-24 h) and an inpatient group. Primary outcomes were 30-day readmission, reoperation, complications and death. Data were analysed using Kruskall-Wallis and ANOVA tests.

Over a 2-year period, 229 patients underwent resection for uncomplicated colorectal conditions. Nineteen patients (8%) were discharged within 8 h, 66 (29%) at 8-24 h and 144 (63%) at >24 h. There were no differences in 30-day readmissions, reoperations or deaths among the three groups. Those discharged at 8 h had shorter operative times and less blood loss. Admitted patients were more likely to require postoperative transfusions, but there were no differences among the groups in any other complication.

Using appropriate selection criteria, early discharge at 6-8 h after colectomy is safe without an increase in readmission, reoperation or mortality.