Predictors of reduced length of stay in minimally invasive colectomy, a 20‐year study

Purpose Minimally invasive colorectal resection is a common surgical procedure indicated for a variety of malignant and benign conditions. Length of stay ( los ) is an important metric in the evaluation of surgical care quality and healthcare expenditure. This study aimed to identify predictors of LOS‐minus‐one, or one day less admission, in minimally invasive colectomy, specifically focusing on the most common procedures of high anterior resection and right hemicolectomy. Methods A retrospective analysis was conducted of two prospectively collected clinical databases of patients who had undergone minimally invasive colectomy by two senior colorectal surgeons at a single Queensland institution from 2003 to 2023. The primary outcome was post‐operative LOS. Patients with median LOS or greater were compared with patients with median LOS‐minus‐one or lower. Univariate and multivariate analyses were conducted to find significant predictors of LOS. Results In total, 1302 patients met the inclusion criteria. The median post‐operative LOS was 3 days. The factors which were the strongest predictors of LOS two days or less post‐colectomy were lower American Society of Anesthesiologists (ASA) ( p < 0.001), malignant indication for surgery ( p = 0.036), operation time of under 120 min ( p < 0.001), and Clavien‐Dindo of one or less ( p = 0.011). Conclusion Key predictors of one day less admission were lower ASA physical status classification, Clavien‐Dindo classification of one or less, operation time of 120 min or less, and malignant indication for operation. This understanding can help to optimise peri‐operative planning in order to ultimately improve patient care and minimise healthcare expenditure.