Evidence map›Paper›PMID 36471062›Full record

ArticleSurgical endoscopy2023

A retrospective analysis of early discharge following minimally invasive colectomy in an enhanced recovery pathway.

Stephan Robitaille, Anna Wang, A Sender Liberman, Patrick Charlebois, Barry Stein, Julio F Fiore, Liane S Feldman, Lawrence Lee

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Stephan RobitailleDepartment of Surgery, McGill University Health Centre, Glen Campus - DS1.3310, 1001 Decarie Boulevard, Montreal, QC, H3G 1A4, Canada.ORCID 0000-0002-0082-7193
Anna WangDepartment of Surgery, McGill University Health Centre, Glen Campus - DS1.3310, 1001 Decarie Boulevard, Montreal, QC, H3G 1A4, Canada.
A Sender LibermanDepartment of Surgery, McGill University Health Centre, Glen Campus - DS1.3310, 1001 Decarie Boulevard, Montreal, QC, H3G 1A4, Canada.
Patrick CharleboisDepartment of Surgery, McGill University Health Centre, Glen Campus - DS1.3310, 1001 Decarie Boulevard, Montreal, QC, H3G 1A4, Canada.
Barry SteinDepartment of Surgery, McGill University Health Centre, Glen Campus - DS1.3310, 1001 Decarie Boulevard, Montreal, QC, H3G 1A4, Canada.
Julio F FioreDepartment of Surgery, McGill University Health Centre, Glen Campus - DS1.3310, 1001 Decarie Boulevard, Montreal, QC, H3G 1A4, Canada.
Liane S FeldmanDepartment of Surgery, McGill University Health Centre, Glen Campus - DS1.3310, 1001 Decarie Boulevard, Montreal, QC, H3G 1A4, Canada.
Lawrence LeeDepartment of Surgery, McGill University Health Centre, Glen Campus - DS1.3310, 1001 Decarie Boulevard, Montreal, QC, H3G 1A4, Canada. larry.lee@mcgill.ca.

Funding

Canadian Institute of Health Research CGS M
6 · The paper itself

Abstract

backgroundThere is increasing evidence to support discharge prior to gastrointestinal recovery following colorectal surgery. Furthermore, many patients are discharged early despite being excluded from an ambulatory colectomy pathway. The objective of this study was to determine the outcomes of patients discharged early following laparoscopic colectomy in an enhanced recovery pathway (ERP).

methodsA retrospective review of all adult patients undergoing elective laparoscopic colectomy at a single university-affiliated colorectal referral center (08/2017-06/2021) was performed. Patients were included if they had undergone elective laparoscopic colectomy or ileostomy closure and excluded if they had been enrolled in an ambulatory colectomy pathway. Patients were then divided into three groups: LOS =1 day, LOS 2-3 days, and LOS 4+ days. The main outcomes were 30-day emergency room (ER) visits and readmissions. Reasons for inpatient stay per post-operative day (POD) were also recorded.

resultsA total of 497 patients were included [LOS1 n = 63 (13%), LOS2-3 n = 284 (57%), and LOS4+ n = 150 (30%)]. There were no differences in patient characteristics, diagnosis, or procedure between the groups. Patients were discharged with gastrointestinal recovery (GI-3) in 54% LOS1 vs. 98% LOS2-3 vs. 100% LOS4+ (p<0.001). Shorter procedure duration, transversus abdominus plane block, and lower opioid requirements were associated with shorter LOS (p<0.001). The absence of flatus was the most common reason to keep patients hospitalized: 61% on POD1, 21% on POD2, and 8% on POD3 (p<0.001). There were no differences in 30-day emergency visits, or readmission between the groups. In the LOS1 group, there were no differences in outcomes between patients with full return of bowel function at discharge compared to those without.

conclusionDischarge on POD1 was not associated with increased emergency department use, complications, or readmissions. Importantly, full return of bowel function at discharge did not affect outcomes. There may be potential to expand eligibility criteria for ambulatory colectomy protocol.

Indexed as

ColectomyPatient DischargeAdultHumansIleostomyPostoperative PeriodRetrospective StudiesAmbulatory colectomyEarly dischargeIleostomy reversalLaparoscopic colectomySame-day discharge

Identifiers

PMID36471062
PMCPMC9734303

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.