Road Towards Ambulatory Colectomy: Patient Outcomes and Experience During a Feasibility Study

Area of Science:

• Colorectal Surgery
• Surgical Pathway Optimization
• Minimally Invasive Surgery

Background:

• Enhanced Recovery Pathways (ERP) are standard for colorectal surgery.
• Same-Day Discharge (SDD) and One-Night Stay (ONS) protocols show feasibility but require robust remote monitoring.
• Scalability and delayed complication diagnosis are concerns with newer protocols.

Purpose of the Study:

• To standardize and implement a One-Night Stay (ONS) colectomy pathway.
• To evaluate the feasibility and outcomes of ONS colectomy using remote monitoring.
• To compare ONS colectomy outcomes with traditional ERP.

Main Methods:

• Implementation of a multimodal remote monitoring system (Interactive Home Monitoring Application, wearable sensors, centralized dashboard).
• Real-time vital sign tracking, twice-daily questionnaires, and serial blood tests (POD 1, 3, 5).
• 1:1 pair-matched control group comparing ONS with traditional ERP.

Main Results:

• ONS patients experienced significantly shorter median length of stay (1 day vs. 4 days).
• Lower postoperative pain scores (VAS -3.0) on postoperative day 1 for ONS patients.
• High patient satisfaction (8.5/10) and rapid improvement in physical activity levels.

Conclusions:

• ONS colectomy, supported by preoperative education and remote monitoring, reduces LOS without compromising safety.
• The ONS pathway demonstrates high patient satisfaction and comparable postoperative outcomes to traditional ERP.
• Remote monitoring and telehealth support are crucial for successful ONS implementation.