Campbell Stephen, Fichera Alessandro, Thomas Scott, Papaconstantinou Harry, Essani Rahila
Division of Colon and Rectal Surgery, Baylor Scott and White Health Central Texas, Temple, Texas.
Division of Colon and Rectal Surgery, Baylor Scott and White Health North Texas, Dallas, Texas.
Proc (Bayl Univ Med Cent). 2021 Sep 16;35(1):24-27. doi: 10.1080/08998280.2021.1973327. eCollection 2022.
Whereas the advancement of minimally invasive surgical techniques and enhanced recovery after surgery (ERAS) pathways for partial colectomies has shortened postoperative length of stay, the ideal length of stay after partial colectomy with or without diverting loop ileostomy is still up for debate. This article examines the safety and efficacy of discharging select patients home from day surgery following partial colectomy. We performed a retrospective review of 7 patients who underwent partial colectomy at one tertiary care center from December 2020 to August 2021. None of our cases suffered complications such as anastomotic leak, surgical site infection, or bowel obstruction or required admission to the hospital. One patient was seen in the emergency department on postoperative day 1 for nausea and vomiting and was managed as an outpatient. A second patient required a fluid bolus in the clinic for high ileostomy output. In conclusion, our study suggests that appropriately selected patients can be successfully managed in the outpatient setting without increased complications following partial colectomy when preoperative preparation and education are put in place alongside our colon ERAS pathway and minimally invasive surgical techniques.
尽管微创外科技术的进步以及部分结肠切除术的术后加速康复(ERAS)路径缩短了术后住院时间,但部分结肠切除术伴或不伴转流性回肠造口术的理想住院时间仍存在争议。本文探讨了部分结肠切除术后选择特定患者进行日间手术并出院回家的安全性和有效性。我们对2020年12月至2021年8月在一家三级医疗中心接受部分结肠切除术的7例患者进行了回顾性研究。我们的病例均未出现吻合口漏、手术部位感染或肠梗阻等并发症,也无需住院治疗。1例患者在术后第1天因恶心呕吐到急诊科就诊,作为门诊患者进行处理。另1例患者在诊所因回肠造口排出量高需要补液。总之,我们的研究表明,当术前准备和教育与我们的结肠ERAS路径及微创外科技术相结合时,经过适当选择的患者在部分结肠切除术后可在门诊成功处理,且并发症不会增加。