Ambulatory discharge after colorectal resection: How early a discharge after surgery is feasible and safe?

AIM: The feasibility and safety of ambulatory (23-h stay) surgery in patients undergoing colorectal resection has been previously demonstrated. The aim of this work was to compare outcomes of patients discharged directly from the postanaesthesia care unit at 6-8 h postsurgery to assess the feasibility of even earlier discharges. METHOD: We performed a retrospective observational study of all patients undergoing intestinal resection with primary anastomosis by a single surgeon at an academic centre over a 2-year period. Patients were divided into three groups: an early discharge group (discharged 6-8 h postsurgery), an ambulatory group (discharged at 8-24 h) and an inpatient group. Primary outcomes were 30-day readmission, reoperation, complications and death. Data were analysed using Kruskall-Wallis and ANOVA tests. RESULTS: Over a 2-year period, 229 patients underwent resection for uncomplicated colorectal conditions. Nineteen patients (8%) were discharged within 8 h, 66 (29%) at 8-24 h and 144 (63%) at >24 h. There were no differences in 30-day readmissions, reoperations or deaths among the three groups. Those discharged at 8 h had shorter operative times and less blood loss. Admitted patients were more likely to require postoperative transfusions, but there were no differences among the groups in any other complication. CONCLUSION: Using appropriate selection criteria, early discharge at 6-8 h after colectomy is safe without an increase in readmission, reoperation or mortality.