Patient perspectives on same-day discharge after elective minimally invasive colorectal surgery

Same-day discharge after minimally invasive colorectal surgery is increasingly implemented, yet little is known about patient perspectives. Incorporating these perspectives is essential to ensure that same-day discharge pathways remain patient-centered and aligned with recovery needs.

A qualitative descriptive study was conducted among adults who underwent elective minimally invasive colectomy or stoma reversal planned for same-day discharge at a university-affiliated colorectal referral center (February 2020-March 2023). Semistructured telephone interviews with 12 core open-ended questions were performed postoperatively between June and August 2023. Purposeful sampling ensured variation in surgical indication, baseline characteristics, and same-day discharge success. Transcriptions were independently coded by 2 reviewers using an inductive thematic analysis.

Of 191 patients planned for same-day discharge, 25 were approached and 17 completed interviews when thematic saturation was reached. Mean time from surgery to interview was 15.3 months (standard deviation 8.3). Mean age was 51 years (standard deviation 16), 58.8% were female, and colon cancer was the most common indication (n = 9). Four themes emerged: (1) need for preparedness and foresight, (2) adjusting to the homecare model, (3) comfort and return of daily function, and (4) factors limiting homecare. Patients emphasized preoperative education, social support, and timely access to care. Reported benefits included improved sleep, emotional comfort, and dietary freedom, whereas challenges involved wound care, injectable medications, and limited community resources. Despite initial hesitancy, most participants expressed satisfaction and willingness to choose same-day discharge again.

Same-day discharge was perceived positively, given adequate preparation, home support, and timely access to services. Incorporating patient input may optimize same-day discharge protocols and recovery experiences.