1 0 8
O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | O C T O B E R 2 0 1 4
stay traditional lengths of time after colectomies, these fast-track dis-
charge patients "do just as well," and those who leave within that first
day often have a lower readmission rate than others who stay longer
than 23 hours. "If patients did worse after surgery, that would be a big
problem," says Dr. Delaney.
Patient characteristics
While the new standards in colectomy — which the surgeons say are
performed on nearly all patients, regardless of how long they're predict-
ed to stay in the hospital — enable a same-day procedure to be done, it's
really the patients that make the difference when it comes to how long
they stay at the hospital and if they can leave within a day. "It's not going
to be the 93-year-old who has a bad heart and no one at home," says Dr.
Delaney. "You have to have the right patients."
Typically, experts say these factors determine how quickly a patient is
discharged following colectomy:
• Home support.
This is one of the most crucial factors for determining
if a patient is eligible for a same-day discharge. Patients can't go home
early if there's no one there to monitor and take care of them.
• Comorbidities.
Patients who can leave within 23 hours tend to be
healthy and have no other major co-morbidities, the surgeons say.
Someone with heart disease or diabetes will likely have a longer recov-
ery.
• Cause for surgery.
A patient who is getting surgery because he has a
small polyp but is otherwise stable will be released much sooner than
someone who is having her colon removed because of a bad case of
Crohn's Disease or diverticulitis, says Dr. Anvari.
• Age.
Age isn't a limiting factor of whether someone is a candidate
for same-day colectomy, but younger, healthier patients generally fare
better.
C O L E C T O M Y
