Universal same-day discharge after colonic resection: a matched cohort study

Enhanced Recovery Protocols (ERPs) have improved outcomes in colorectal surgery. Same-day discharge (SDD) after colonic resection is promising but often limited to highly selected patients. This study evaluates the safety and efficacy of a universal same-day discharge (USDD) program compared to traditional ERPs. The objective was to assess if USDD in a broader patient population is non-inferior to traditional ERP in terms of 30-day complications, readmissions, and reoperations. This was a retrospective matched cohort study at a single U.S. institution that launched a USDD program in May 2022. Thirty-six patients in the USDD program were compared to a matched control group receiving traditional ERP. USDD eligibility criteria included outpatient agreement, minimally invasive approach, no new stoma, and caregiver availability. Main outcome measures were 30-day post-operative complications, ED visits, readmissions, and reoperations. The USDD group had shorter operative times, increased TAP block use, and lower intraoperative fluid administration. No significant differences were found in 30-day complications or reoperations between groups. However, ED visits and readmission rates were higher in the USDD group. USDD appears to be safe and non-inferior to traditional ERP for selected patients. SDD can potentially be safely expanded to a wider patient population, but further prospective studies are needed.