van Outersterp L, Laurijs S H H, Amraoui Y El, Peeters A E, Verdaasdonk E E G
Department of Surgery, Jeroen Bosch Ziekenhuis, 'S-Hertogenbosch, The Netherlands.
Surg Endosc. 2025 Jun;39(6):3654-3661. doi: 10.1007/s00464-025-11716-2. Epub 2025 Apr 29.
Laparoscopic colorectal surgery combined with Enhanced Recovery after Surgery (ERAS) has improved patient outcomes by promoting faster recovery, reducing pain, and lowering the risk of complications. However, increasing demand on hospital capacity for clinical admissions and the shortage of healthcare professionals remains challenging. Home monitoring after surgical procedures and early discharge offers a potential solution. This study aims to assess the feasibility, safety and patient satisfaction with early discharge following elective colorectal surgery using continuous monitoring of vital signs and questionnaires.
A prospective, single-centre, interventional study. Patients who meet the discharge criteria could leave on day one or two after surgery, monitored at home with sensors for vital signs and health questionnaires.
Of 51 patients, 30 (58.8%) were discharged early. The results show successful early discharge in 80% (24 out of 30 patients) with a readmission rate of 20% of which 13.3% due to problems with the monitoring system. None of these readmissions were due to deviations in vital sign measurement at home. The patient satisfaction was high ranging between 6 and 7 (out of 7).
Early discharge with continue monitoring is feasible for a selected group of colorectal surgery patients. No patients were readmitted because of serious complications. Further research should focus on expending the sample size and investigating the impact of early discharge without continuous monitoring.
腹腔镜结直肠手术联合术后加速康复(ERAS)通过促进更快康复、减轻疼痛和降低并发症风险改善了患者预后。然而,临床入院对医院容量的需求不断增加以及医疗保健专业人员短缺仍然是一项挑战。手术后的家庭监测和早期出院提供了一种潜在的解决方案。本研究旨在通过持续监测生命体征和问卷调查来评估择期结直肠手术后早期出院的可行性、安全性和患者满意度。
一项前瞻性、单中心、干预性研究。符合出院标准的患者可在术后第一天或第二天出院,在家中使用生命体征传感器和健康问卷进行监测。
51例患者中,30例(58.8%)早期出院。结果显示80%(30例患者中的24例)成功早期出院,再入院率为20%,其中13.3%是由于监测系统问题。这些再入院均非因家中生命体征测量偏差所致。患者满意度较高,在6至7分(满分7分)之间。
对于部分结直肠手术患者,持续监测下的早期出院是可行的。没有患者因严重并发症而再入院。进一步的研究应侧重于扩大样本量,并调查无持续监测情况下早期出院的影响。