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Forty-Eight Hours Hospital-Stay after Fast-Track Laparoscopic Colorectal Surgery: A Prospective Study

Ihab S Ahmed, Mahmoud AM, Debaky Y, Abed SMA and Adlan S

Objective: To examine the safety and feasibility of a two-day hospital stay regimen after laparoscopic colorectal surgery in a referral center.
Patients and methods: This prospective study involved 50 patients with colorectal cancer scheduled for laparoscopic colorectal surgery (LCS). They were randomly allocated into one of two groups; FTS Group (n=25) had LCS within fast-track regimen extending for 48 hours postoperatively only and Control Group (n=25) had LCS with conventional care program. Fast-track care was employed with its pre-, intra- and postoperative phases. In FTS, patients were discharged after 48 hours if discharge criteria were fulfilled (ambulating, afebrile patient tolerating oral feeding under adequate pain control). Postoperative complications were recorded.
Results: The two groups had comparable baseline characteristics, outcome of surgery and rate of complications. There was no significant difference between the two groups in the rates of conversion to laparotomy (p=1.000), readmission (p=0.235), and reoperation (p=0.609). Fifteen patients (75%) of the FTS group met discharge criteria and discharged 48 hours after surgery. Delayed discharge was due to postoperative ileus (n=3), uncontrolled blood sugar (n=1) and chest infection (n=1). The median duration of hospital stay in the Control group was 7 days (range: 6-9 days).
Conclusion: A two-day hospital stay after LCS is safe and feasible under fast-track regimen. It did not increase the rate of complications of readmissions. Patients fulfilling standardized criteria can be safely discharged on the second postoperative day with a low readmission and complication rate.