Popeskou Sotirios Georgios, Christou Niki, Panteleimonitis Sofoklis, Langford Ed, Qureshi Tahseen, Parvaiz Amjad
Department of Surgery, Regional Hospital of Lugano, 6900 Lugano, Switzerland.
Digestive Surgery Department, University Hospital Limoges, 87000 Limoges, France.
J Clin Med. 2022 Aug 29;11(17):5068. doi: 10.3390/jcm11175068.
Enhanced or accelerating recovery programs have significantly reduced hospital length stay after elective colorectal interventions. Our work aims at reporting an initial experience with ambulatory laparoscopic colectomy (ALC) to assess the criteria of discharge and outcomes. Between 2006 and 2016, data regarding patients having benefited from elective laparoscopic colorectal resections in two main centres in the United Kingdom have been analysed. Both benign and malignant pathologies were included. A standardised enhanced recovery program was performed for each patient, except epidural analgesia was replaced with single shot spinal infiltration. Patients were followed up through a telephone call system by a nurse. Short-term clinical outcomes were analysed. A total of 833 patients were included and 51 (6.1%) were discharged within 24 h following surgery. Of these, 4 out of 51 (7.8%) patients came back hospital within 30 days of discharge; 2 (3.9%) required reoperation (Small bowel obstruction and wound abscess drainage). This study highlights that a 24-h discharge following elective laparoscopic colorectal interventions seems safe and feasible in selected patients. Although challenging to achieve, a standardised approach to laparoscopic surgery in combination with strict adherence to an enhanced recovery protocol are the fundamental elements of this path.
强化或加速康复计划显著缩短了择期结直肠手术后的住院时间。我们的工作旨在报告门诊腹腔镜结肠切除术（ALC）的初步经验，以评估出院标准和手术结果。2006年至2016年期间，对英国两个主要中心接受择期腹腔镜结直肠切除术患者的数据进行了分析。纳入了良性和恶性病变。除了用单次脊髓浸润替代硬膜外镇痛外，对每位患者都实施了标准化的加速康复计划。通过护士电话随访系统对患者进行随访，并分析短期临床结果。共纳入833例患者，其中51例（6.1%）在术后24小时内出院。其中，51例中有4例（7.8%）患者在出院后30天内再次入院；2例（3.9%）需要再次手术（小肠梗阻和伤口脓肿引流）。这项研究表明，择期腹腔镜结直肠手术后24小时出院在部分患者中似乎是安全可行的。尽管实现这一目标具有挑战性，但腹腔镜手术的标准化方法与严格遵守加速康复方案相结合是实现这一目标的基本要素。
