Same-Day Colectomy: is it Safe for Patients?

University of Arizona

Status

Enrolling

Conditions

Colectomy Left/Right/Total Under Laparotomy

Colorectal

Colectomy

Treatments

Other: Same-Day Colectomy

Study type

Interventional

Funder types

Other

Identifiers

NCT07176715

STUDY00003441

Details and patient eligibility

About

This is a prospective cohort study of outcomes of patients undergoing outpatient colorectal surgery at a single institution to study outpatient colectomy as a viable treatment option for a select group of patients requiring colon and rectal surgery.

Enrollment

150 estimated patients

Sex

All

Ages

18 to 70 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Ages 18-70
Undergoing robotic-assisted right colectomy, sigmoidectomy, or low anterior resection.
Able to perform greater than 4 metabolic equivalents (METS) without shortness of breath
Must have a designated adult who can care for them at home postoperatively until their in-person clinic visit
Access to a cell phone or computer and running water.
Successfully completed pre-operative and post-operative education
Medical criteria:
Well controlled hypertension with systolic blood pressure < 140 controlled by less than two medications which they are compliant with
Well controlled diabetes on oral agents only with blood glucose level < 180 on daily checks
Anti-platelet agents including aspirin, clopidogrel, prasugrel, ticagrelor or ticlopidine will be stopped 7 days preoperatively and restarted on postoperative day 1. See exclusion criteria 7 for specific exclusion criteria regarding antiplatelet agents.

Exclusion criteria

Medical criteria:
Neurocognitive deficits not allowing for adequate preoperative education
Congestive heart failure with EF < 45%
Symptomatic aortic stenosis causing heart failure, syncope, dyspnea or angina
Pulmonary fibrosis or pulmonary hypertension
COPD or home oxygen use > 2L
Chronic kidney disease of any stage.
Lack of a caregiver at home or functionally bed-bound
Ultralow pelvic resection
Need for ostomy creation intraoperatively
Operative time greater than 5 hours as this likely indicates a complex case and dissection necessitating closer monitoring in the hospital
Conversion to open procedure intraoperatively
Patients receiving antiplatelet agents such as clopidogrel, prasugrel, ticagrelor or ticlopidine within one year of coronary or carotid stent implantation, TAVR or LAAO placement.
Patients on therapeutic anticoagulation medications such as warfarin, Eliquis, Xarelto, Enoxaparin
Current tobacco use
Patients who were unable to complete preoperative education, do not feel comfortable with care at home, or do not have an available caregiver for the first 7 postoperative days
Any surgical history that would preclude safe abdominal entry for robotic surgery