Our Summary

The research paper discusses the possibility of patients going home on the same day after having a colectomy (a surgery to remove part of the colon). This concept, called ambulatory colectomy, has become more plausible due to Enhanced Recovery After Surgery (ERAS) protocols, which help patients recover quicker.

The researchers reviewed cases from February 2019 to August 2021 where patients were discharged on the same day after a colectomy. These patients were carefully selected based on their health before the surgery and how they were doing after the operation. They were also closely monitored through telehealth (remote healthcare services) and communication with their doctors until their one-week post-surgery check-up.

Out of 69 patients who were discharged on the same day, only one patient had to be readmitted to the hospital. All the surgeries were done using a robotic-assisted approach and none of them had to be converted to an open surgery. The most common procedures were the low anterior resection (surgery to remove the lower part of the rectum) and right hemicolectomy (surgery to remove the right side of the colon).

The study concludes that with the right patient education, clear communication between healthcare teams, and recent technological advancements, it’s possible and safe for patients to be discharged on the same day after a colectomy.

FAQs

  1. What is an ambulatory colectomy and what makes it possible?
  2. How are patients monitored and followed up after being discharged on the same day of their colectomy surgery?
  3. What were the most common procedures performed on the patients who were discharged on the same day after a colectomy, according to the research?

Doctor’s Tip

A helpful tip a doctor might give to a patient about colectomy is to follow the Enhanced Recovery After Surgery (ERAS) protocols to help speed up the recovery process. This can include staying active, managing pain effectively, and ensuring proper nutrition and hydration. It’s also important to closely follow post-operative care instructions and attend all follow-up appointments to monitor progress and prevent complications.

Suitable For

Patients who are typically recommended for colectomy include those with colorectal cancer, inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease), diverticulitis, bowel obstruction, or other conditions that affect the colon. The decision to undergo a colectomy is usually made after other treatment options have been exhausted or if there is a risk of complications or recurrence of the condition. Patients who are in good overall health and have a lower risk of complications are more likely to be recommended for ambulatory colectomy.

Timeline

Before the colectomy:

  • Patient meets with healthcare providers to discuss the surgery and potential risks
  • Patient undergoes pre-operative testing and preparation
  • Patient follows pre-operative instructions, such as fasting and medication adjustments

After the colectomy:

  • Patient is closely monitored in the recovery room for any complications
  • Patient gradually resumes eating and walking to promote recovery
  • Patient may experience pain, fatigue, and changes in bowel movements
  • Patient receives post-operative care and instructions for at-home recovery
  • Patient follows up with healthcare providers for check-ups and monitoring of recovery progress

Overall, the timeline of a patient’s experience before and after a colectomy involves thorough preparation, careful monitoring, and support for a successful recovery.

What to Ask Your Doctor

  1. Is ambulatory colectomy an option for me?
  2. What criteria do I need to meet in order to be considered for same-day discharge after a colectomy?
  3. What are the potential risks and complications associated with same-day discharge after a colectomy?
  4. How will my pain be managed after the surgery if I go home on the same day?
  5. How will I be monitored and supported at home after the surgery?
  6. What signs or symptoms should I watch for that may indicate a complication or need for medical attention after going home?
  7. How often will I have follow-up appointments after the surgery if I am discharged on the same day?
  8. What should I expect in terms of my recovery process if I go home on the same day after a colectomy?
  9. Are there any specific activities or restrictions I should be aware of after going home on the same day following a colectomy?
  10. What are my options for post-operative care and support if I choose to go home on the same day after a colectomy?

Reference

Authors: Curfman KR, Poola AS, Blair GE, Kosnik CL, Pille SA, Thilo EL, Hawkins ME, Rashidi L. Journal: Am J Surg. 2022 Aug;224(2):757-760. doi: 10.1016/j.amjsurg.2022.04.039. Epub 2022 May 11. PMID: 35570059