Literature DB >> 29022790

Accelerated discharge within 72 hours of colorectal cancer resection using simple discharge criteria.

A Emmanuel1, E Chohda1, C Botfield1, J Ellul1.   

Abstract

Introduction Short hospital stays and accelerated discharge within 72 hours following colorectal cancer resections have not been widely achieved. Series reporting on accelerated discharge involve heterogeneous patient populations and exclude important groups. Strict adherence to some discharge requirements may lead to delays in discharge. The aim of this study was to evaluate the safety and feasibility of accelerated discharge within 72 hours of all elective colorectal cancer resections using simple discharge criteria. Methods Elective colorectal cancer resections performed between August 2009 and December 2015 by a single surgeon were reviewed. Perioperative care was based on an enhanced recovery programme. A set of simplified discharge criteria were used. Outcomes including postoperative complications, readmissions and reoperations were compared between patients discharged within 72 hours and those with a longer postoperative stay. Results Overall, 256 colorectal cancer resections (90% laparoscopic) were performed. The mean patient age was 70.8 years. The median length of stay was 3 days. Fifty-eight per cent of all patients and sixty-three per cent of patients undergoing laparoscopic surgery were discharged within 72 hours. Accelerated discharge was not associated with adverse outcomes compared with delayed discharge. Patients discharged within 72 hours had significantly fewer postoperative complications, readmissions and reoperations. Open surgery and stoma formation were associated with discharge after 72 hours but not age, co-morbidities, neoadjuvant chemoradiation or surgical procedure. Conclusions Accelerated discharge within 72 hours of elective colorectal resection for cancer is safely achievable for the majority of patients without compromising short-term outcomes.

Entities:  

Keywords:  Accelerated discharge; Colorectal cancer; Colorectal surgery; Length of stay

Mesh:

Year:  2017        PMID: 29022790      PMCID: PMC5838672          DOI: 10.1308/rcsann.2017.0149

Source DB:  PubMed          Journal:  Ann R Coll Surg Engl        ISSN: 0035-8843            Impact factor:   1.891


  22 in total

1.  Colonic surgery with accelerated rehabilitation or conventional care.

Authors:  Linda Basse; Jens Erik Thorbøl; Kristine Løssl; Henrik Kehlet
Journal:  Dis Colon Rectum       Date:  2004-03       Impact factor: 4.585

Review 2.  Hospital discharge criteria following colorectal surgery: a systematic review.

Authors:  J F Fiore; L Browning; A Bialocerkowski; R L Gruen; I G Faragher; L Denehy
Journal:  Colorectal Dis       Date:  2012-03       Impact factor: 3.788

3.  Convalescence after colonic surgery with fast-track vs conventional care.

Authors:  D H Jakobsen; E Sonne; J Andreasen; H Kehlet
Journal:  Colorectal Dis       Date:  2006-10       Impact factor: 3.788

4.  Readmission rates after a planned hospital stay of 2 versus 3 days in fast-track colonic surgery.

Authors:  J Andersen; D Hjort-Jakobsen; P S Christiansen; H Kehlet
Journal:  Br J Surg       Date:  2007-07       Impact factor: 6.939

Review 5.  Enhanced recovery in colorectal resections: a systematic review and meta-analysis.

Authors:  C J Walter; J Collin; J C Dumville; P J Drew; J R Monson
Journal:  Colorectal Dis       Date:  2009-02-04       Impact factor: 3.788

6.  Criteria to determine readiness for hospital discharge following colorectal surgery: an international consensus using the Delphi technique.

Authors:  Julio F Fiore; Andrea Bialocerkowski; Laura Browning; Ian G Faragher; Linda Denehy
Journal:  Dis Colon Rectum       Date:  2012-04       Impact factor: 4.585

Review 7.  Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations.

Authors:  U O Gustafsson; M J Scott; W Schwenk; N Demartines; D Roulin; N Francis; C E McNaught; J MacFie; A S Liberman; M Soop; A Hill; R H Kennedy; D N Lobo; K Fearon; O Ljungqvist
Journal:  Clin Nutr       Date:  2012-09-28       Impact factor: 7.324

8.  Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study).

Authors:  Malaika S Vlug; Jan Wind; Markus W Hollmann; Dirk T Ubbink; Huib A Cense; Alexander F Engel; Michael F Gerhards; Bart A van Wagensveld; Edwin S van der Zaag; Anna A W van Geloven; Mirjam A G Sprangers; Miguel A Cuesta; Willem A Bemelman
Journal:  Ann Surg       Date:  2011-12       Impact factor: 12.969

9.  23-hour-stay laparoscopic colectomy.

Authors:  B F Levy; M J P Scott; W J Fawcett; T A Rockall
Journal:  Dis Colon Rectum       Date:  2009-07       Impact factor: 4.585

10.  Multicenter randomized controlled trial of conventional versus laparoscopic surgery for colorectal cancer within an enhanced recovery programme: EnROL.

Authors:  Robin H Kennedy; E Anne Francis; Rose Wharton; Jane M Blazeby; Philip Quirke; Nicholas P West; Susan J Dutton
Journal:  J Clin Oncol       Date:  2014-05-05       Impact factor: 44.544

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