Same day discharge in colorectal surgery: Who requires unplanned overnight monitoring?

BACKGROUND: Enhanced Recovery After Surgery protocols and minimally invasive surgery have decreased colorectal length of stay. Our institution implemented a Same Day Discharge (SDD) colorectal protocol, and this study evaluates factors associated with unplanned admission.

METHODS: . Retrospective review was performed from February 2019 to January 2022. Admitted SDD candidates were identified, and their course evaluated. Demographics, clinical characteristics, and outcomes were compared between cohorts.

RESULTS: Review identified 152 potential SDD patients, 47 successfully discharged. Of the 105 admitted patients, the most common reasons were operative complexity (47.6 ​%) and social reasons (23.8 ​%). No differences were seen in operative times, gender, BMI, anticoagulation, or diabetes. The admission cohort was more likely to undergo low anterior resection or right colectomy and was older in age. Case complexity was the highest factor for affecting discharge.

CONCLUSION: SDD can be feasible after colectomy, but in certain patients may require deviation. The most common factors requiring admission were complexity and social factors.