Clinical Impact of Telemedicine Interventions on Outcomes After Abdominal Surgery: A Systematic Review of Randomized Controlled Trials.

Abdominal surgery is associated with significant postoperative morbidity and healthcare utilization, prompting the exploration of telemedicine as a tool to improve outcomes. While previous reviews have examined telemedicine in specific surgical contexts, this systematic review provides a comprehensive synthesis of randomized controlled trials (RCTs) across diverse abdominal procedures. This systematic review evaluates the clinical impact of telemedicine interventions on postoperative outcomes, including morbidity, patient satisfaction, readmissions, and cost-effectiveness. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic search of PubMed, Scopus, Web of Science, and ClinicalTrials.gov for RCTs evaluating telemedicine in abdominal surgery. Eligible studies reported clinical outcomes such as recovery time, readmissions, and patient satisfaction. Two reviewers independently screened records, extracted data, and assessed risk of bias using the Cochrane Risk of Bias 2 (RoB 2) tool. Due to heterogeneity, findings were synthesized narratively. The review included 12 RCTs encompassing various abdominal surgeries and telemedicine approaches. Results demonstrated that telemedicine interventions consistently improved patient satisfaction and showed noninferiority compared to traditional in-person follow-up. Several studies reported reduced recovery times and improved postoperative monitoring through remote technologies. However, effects on hospital readmissions were mixed, with some interventions showing benefit while others demonstrated no significant difference. Cost-effectiveness analyses indicated potential savings from smartphone-based follow-up systems. Most studies exhibited low risk of bias, though some limitations were noted regarding unblinded designs and subjective outcome measures. These findings suggest that telemedicine offers valuable opportunities to enhance postoperative care after abdominal surgery, particularly in improving patient-centered outcomes and recovery experiences. The variable impact on clinical outcomes like readmissions highlights the importance of tailoring interventions to specific surgical contexts and patient needs. Future research should focus on standardizing outcome measures, evaluating long-term effects, and addressing implementation challenges to maximize the potential of telemedicine in surgical care.