Laparoscopic colorectal surgery and discharge within 24 h-who is at risk for readmission?

Abstract

The aim was to describe risk factors for hospital readmission in patients undergoing laparoscopic colorectal procedures and being discharged in ≤24h. All consecutive patients undergoing minimally invasive colorectal surgery between 2010 and 2019 from a single institution were retrospectively reviewed. All patients were included in an enhanced recovery programme. Patients who met criteria for hospital discharge were compared according to the need for readmission in a 45-day follow-up. In all, 664 patients underwent minimally invasive colorectal surgery during the study period and 237 (35.7%) were discharged in ≤24h. Readmission was required in 16 (6.8%) patients discharged in ≤24h and no postoperative mortality was observed in this group. Patients discharged in ≤24h were more likely to have benign disease (P<0.001), fewer associated procedures (P<0.025) and intracorporeal anastomoses (P<0.001). The type of surgical procedure (abdominoperineal resection), low rectal tumour, malignant disease, older age and longer operating time were associated with readmission. Age (OR 1.06; P=0.037), malignant disease (OR 4.39; P=0.05) and operating time (OR 1.03; P<0.001) were identified as independent predictive factors for readmission amongst patients being discharged in ≤24h. Highly selected patients undergoing minimally invasive procedures in colorectal surgery may be safely discharged within 24h following the procedure. High-risk features for readmission include older age, malignant disease and longer operating time.