Short Hospital Stay after Colorectal Surgery
Seance of wednesday 24 january 2018 (LES CONDITIONS DU RETOUR PRECOCE A DOMICILE APRES CHIRURGIE VISCERALE MAJEURE)
DOI number : 10.26299/4d3h-zc07/emem.2017.4.016
Abstract
These past years, under the influence of the ERAS (Enhanced Recovery After Surgery) program and with the contributions of the ambulatory surgery, the length of stay in hospital after colorectal surgery has strongly decreased. This decrease allows patients to get back home while the risk of potentially lethal complication (bleeding, fistula) are not ruled out. To assure the patients safety without loss of chance compared to hospital stay, it is necessary to modify the clinical pathway’s organisation for colorectal surgery:
• By involving the patient and his relatives directly in his coverage with specific therapeutic education which begins at the first consultation.
• By coordinating every medical teams before and after the hospital stay.
• By adopting a logical risks management (“a priori” management) with a post-operative home follow up according to specific algorithms through new communication’s technologies.
• By assuring H 24 team availability to immediately answer to the slightest problem or a deviation to the predictable events.
Using these rules, colorectal surgery can be considered in expert centers with short hospital stay (less than 5 days) or outpatient procedure. Mobi-mortality must be comparable with colorectal surgery with ERAS program.
• By involving the patient and his relatives directly in his coverage with specific therapeutic education which begins at the first consultation.
• By coordinating every medical teams before and after the hospital stay.
• By adopting a logical risks management (“a priori” management) with a post-operative home follow up according to specific algorithms through new communication’s technologies.
• By assuring H 24 team availability to immediately answer to the slightest problem or a deviation to the predictable events.
Using these rules, colorectal surgery can be considered in expert centers with short hospital stay (less than 5 days) or outpatient procedure. Mobi-mortality must be comparable with colorectal surgery with ERAS program.