Authors (including presenting author) :
Shum NF, Choi HK, Lam MS, Tang YC, Foo CC, Lo SH,Law WL.
Affiliation :
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
Introduction :
The move toward outpatient and same-day surgical services has been phenomenal in recent years. In this study, we compared the same-day admission (SDA) and traditional surgery management in Queen Mary Hospital to evaluate the benefits of using SDA.
Objectives :
This study aimed to evaluate whether same-day admission for patients undergoing elective colectomy with Enhanced After Surgery Program is applicable.
Methodology :
We retrospectively reviewed the data from patients admitted for elective colectomy surgeries from October 2018 to December 2020. All the patients were underwent Enhanced Recovery After Surgery Program. SDA patients were recruited at the colorectal clinic by convenience sampling. SDA patients were then instructed by Colorectal Nurse Specialist to perform preoperative preparations at home including dietary, bowel, drug management and fasting, etc. The traditional group patients followed usual hospital practice and to be admitted one day before surgery.
Result & Outcome :
A total of 166 (96 male, 70 female) patients with mean age of 73.08 (SD12.3, 27-93) were recruited for elective colectomy surgery under the Enhanced After Surgery Program. One hundred and eleven (66.9%,) patients were admitted the day before surgery while 55 (33.1%) patients were admitted on same day of surgery. Ninety-four (56.6%) patients underwent hemicolectomy while 72 (43.4%) patients underwent anterior resection or low anterior resection. There was no significant differences (p>0.05) between 2 groups in gender, comorbidities, surgical site and surgery approaches. SDA group patients did not shown difference in early feeding, ambulation or passage of first bowel motion or did not result in any complication or readmission as compared with traditional group. However, the mean postop length of hospital stay was significantly decreased in the SDA patients as compared with traditional group (3.78 vs 5.95 days, p=0.001). There was statistically significant differences between age (2.02 vs, p=0.003) and ASA score (2.02 vs 2.44 score, p=0.000) as compared with traditional group.
Same-day admission surgery can be recommended and selection for young and smart patient group is pivotal and can help to further shorten the hospital stay without adversely affecting clinical outcomes
