Our Summary

The research looked at which patients could safely have a certain type of bowel surgery (called a colectomy) and leave the hospital within four days, without any post-surgery complications.

They looked at the medical records of patients who had this surgery in 2018 and 2019 and found a total of 110 people to study. Most of these patients were being treated for cancer.

The results showed that age, diabetes, and the reason for the surgery (specifically, sigmoidectomy for diverticulosis) were the most important factors in deciding if a patient could safely have this surgery and leave the hospital within four days.

Patients under the age of 65 who were having surgery for diverticulosis had the best chance (83.3%) of being able to leave the hospital soon after their surgery. The chance of a quick discharge increased to between 92% and 96.9% if an improved recovery process (known as the ERAS protocol) was used.

However, patients over the age of 65 with diabetes had the lowest chance (8.3%) of a quick discharge, even with the improved recovery process.

The research concluded that this type of surgery and quick discharge should not be offered to patients over 65 with diabetes. For other patients, including those under 65 and those over 65 without diabetes, the surgery and quick discharge could be possible, as long as the improved recovery process was used.

FAQs

  1. What factors did the research identify as most important for determining if a patient could safely have a sigmoidectomy and leave the hospital within four days?
  2. What is the likelihood of a quick discharge for patients under the age of 65 undergoing surgery for diverticulosis?
  3. Should a sigmoidectomy and quick discharge be offered to patients over 65 with diabetes according to the research?

Doctor’s Tip

A doctor might advise a patient undergoing sigmoidectomy to follow the ERAS protocol for improved recovery and a higher chance of being able to leave the hospital within four days. Patients under 65 and without diabetes have the best chance of a quick discharge, while patients over 65 with diabetes may not be good candidates for this approach. It is important to discuss individual risk factors and recovery options with your healthcare provider before undergoing surgery.

Suitable For

Patients who are typically recommended sigmoidectomy are those under the age of 65 who are having surgery for diverticulosis and do not have diabetes. These patients have the best chance of being able to leave the hospital within four days after surgery. Additionally, patients over 65 without diabetes may also be considered for sigmoidectomy with the use of the ERAS protocol for improved recovery. However, patients over 65 with diabetes are not recommended for this type of surgery and quick discharge.

Timeline

Before sigmoidectomy:

  • Patient is diagnosed with a condition that requires sigmoidectomy, such as diverticulosis or cancer.
  • Patient undergoes pre-operative testing and preparation, including consultations with the surgeon and anesthesiologist.
  • Surgery is scheduled and the patient is instructed on pre-operative instructions, such as fasting.
  • Patient undergoes sigmoidectomy surgery, which involves removing part of the sigmoid colon.
  • Patient is monitored in the hospital post-surgery for complications and recovery.

After sigmoidectomy:

  • Patient is monitored closely for any post-surgery complications, such as infection or bleeding.
  • Patient is gradually allowed to start eating and drinking, and is encouraged to walk to aid in recovery.
  • Patient is discharged from the hospital once they are deemed stable and able to continue recovery at home.
  • Patient follows up with their surgeon for post-operative care and monitoring.
  • Patient may undergo physical therapy or rehabilitation to aid in recovery and regain strength.
  • Patient gradually resumes normal activities and diet, while following any post-operative care instructions provided by their healthcare team.

What to Ask Your Doctor

  1. What is a sigmoidectomy and why is it being recommended for me?
  2. What are the potential risks and complications associated with sigmoidectomy?
  3. How long is the typical recovery time after a sigmoidectomy?
  4. Am I a suitable candidate for a quick discharge (within four days) after the surgery?
  5. How will the ERAS protocol improve my recovery process?
  6. Are there any alternative treatment options available for my condition?
  7. What is the success rate of sigmoidectomy for diverticulosis in patients under the age of 65?
  8. How will my diabetes diagnosis impact my recovery and potential discharge time?
  9. What steps can I take to prepare for a successful surgery and recovery process?
  10. Are there any specific dietary or lifestyle changes I should make before or after the surgery?

Reference

Authors: Bourgouin S, Monchal T, Schlienger G, Franck L, Lacroix G, Balandraud P. Journal: J Visc Surg. 2022 Feb;159(1):21-30. doi: 10.1016/j.jviscsurg.2020.11.012. Epub 2020 Dec 19. PMID: 33349570