Evidence map›Paper›PMID 37121985›Full record

SynthesisInternational journal of colorectal disease2023

Same-day discharge (SDD) vs standard enhanced recovery after surgery (ERAS) protocols for major colorectal surgery: a systematic review.

V Zheng, I J Y Wee, H R Abdullah, S Tan, E K W Tan, I Seow-En

Abstract readComparative StudySystematic Review
In one paragraph

Synthesis in International journal of colorectal disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 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

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. Article
  5. Review
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  8. Observational
  9. Review
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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

6 authors.

V Zheng *Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
I J Y Wee *Department of Colorectal Surgery, Singapore General Hospital, Singapore City, Singapore.ORCID https://orcid.org/0000-0001-8778-1943
H R AbdullahDepartment of Anaesthesiology, Singapore General Hospital, Singapore City, Singapore.ORCID https://orcid.org/0000-0003-1916-0832
S TanDepartment of Anaesthesiology, Singapore General Hospital, Singapore City, Singapore.ORCID https://orcid.org/0000-0003-4876-5427
E K W TanDepartment of Colorectal Surgery, Singapore General Hospital, Singapore City, Singapore.ORCID https://orcid.org/0000-0002-0771-5063
I Seow-EnDepartment of Colorectal Surgery, Singapore General Hospital, Singapore City, Singapore. isaac.seow.en@gmail.com.ORCID https://orcid.org/0000-0001-8287-6812

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnhanced recovery after surgery (ERAS) programs are well-established, resulting in improved outcomes and shorter length of hospital stay (LOS). Same-day discharge (SDD), or "hyper-ERAS", is a natural progression of ERAS. This systematic review aims to compare the safety and efficacy of SDD against conventional ERAS in colorectal surgery.

methodsThe protocol was prospectively registered in PROSPERO (394793). A systematic search was performed in major databases to identify relevant articles, and a narrative systematic review was performed. Primary outcomes were readmission rates and length of hospital stay (LOS). Secondary outcomes were operative time and blood loss, postoperative pain, morbidity, nausea or vomiting, and patient satisfaction. Risks of bias was assessed using the ROBINS-I tool.

resultsThirteen studies were included, with five single-arm and eight comparative studies, of which one was a randomised controlled trial. This comprised a total of 38,854 patients (SDD: 1622; ERAS: 37,232). Of the 1622 patients on the SDD pathway, 1590 patients (98%) were successfully discharged within 24 h of surgery. While most studies had an overall low risk of bias, there was considerable variability in inclusion criteria, types of surgery or anaesthesia, and discharge criteria. SDD resulted in a significantly reduced postoperative LOS, without increasing risk of 30-day readmission. Intraoperative blood loss and postoperative morbidity rates were comparable between both groups. Operative duration was shorter in the SDD group. Patient-reported satisfaction was high in the SDD cohort.

conclusionSDD protocols appear to be safe and feasible in selected patients undergoing major colorectal operations. Randomised controlled trials are necessary to further substantiate these findings.

Indexed as

Digestive System Surgical ProceduresEnhanced Recovery After SurgeryColonFeasibility StudiesHumansLength of StayPatient DischargePostoperative ComplicationsPostoperative PainRandomized Controlled Trials as TopicRectumColorectal surgeryEnhanced recovery after surgeryERAS, SDDSame-day discharge

Identifiers

PMID37121985
PMCPMC10149457

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Registered trials

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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.