Analysis of criteria and safety of early discharge after elective colorectal surgery with anastomosis

Introduction: Thanks to minimally invasive techniques and effective perioperative protocols, morbidity and hospital stay associated with colorectal surgery can be reduced. After elective colorectal procedures, some patients may be discharged within 72 hours. However, early discharge is not a routine practice, and its criteria are unclear. Method: A retrospective cohort study was conducted among patients who underwent elective colorectal surgery with anastomosis between March 2022 and May 2024. We analyzed the relationship between early discharge (<72 hours) and 30-day morbidity as well as unplanned hospital readmissions. To identify factors influencing successful early discharge, we examined demographic, medical history, intraoperative, and postoperative data. Results: A total of 109 patients underwent elective colorectal surgery. There were 85 laparoscopic, 8 robot-assisted, 4 open procedures and 12 stoma closures. The 30-day morbidity rate was 8.25% (n = 9), with severe morbidity (Clavien-Dindo 3b) at 4.6% (n = 5). Cases with complications within 72 hours (n = 9) were excluded. After an uncomplicated postoperative course, 30 patients were discharged early, while 70 patients had longer hospital stay (hospital stay: 67.5 +/- 4.13 vs. 99.8 +/- 2.06 hours; p = 0.0001). The groups were similar in age (57.17 +/- 5.27 vs. 61.94 +/- 2.75 years; p = 0.09), gender (p = 0.83), body mass index (p = 0.13), and performance status (p = 0.85). Bowel function recovery was comparable (31.0 +/- 3.84 vs. 34.5 +/- 3.49 hours; p = 0.26). Right- and left-sided resections were equally represented in both groups (p = 0.28), stoma closures were more frequent in the early discharge group (11 vs. 1; p<0.00001). There was no readmission, morbidity, or mortality within 30 days in either group. Conclusion: Following uncomplicated elective colorectal resections and stoma closures, early discharge within 72 hours is safe. Orv Hetil. 2025; 166(4): 139-145.