ThTP4.8 Day 1 post-operative discharge following RAS Colorectal Cancer Resections; exciting potential in helping solve the NHS bed crisis
Carina McGuire, Faid Khopekar, James Saldanha, Segun Komolafe, Fraser Maxwell- Surgery
Abstract
Aims
The NHS is under significant bed strain. Optimising safe, early discharge of elective patients post-operatively should form part of the response to these pressures. We present the results of a single centre retrospective study looking at day 1 post operative (PO) discharge and 30 day readmission rate (RR) in patients who had undergone robotic assisted (RAS) colorectal cancer (CRC) surgical resection.
Methods
Using the hospital’s theatre database, we identified all RAS CRC resection patients from 2nd May 2022 until 17th January 2023. We documented PO LOS using data from ‘Trakcare’ and separated those patients discharged day 1 from those discharged >day 1 to compare RR.
Results
The median LOS for patients undergoing RAS CRC resections (n=56) was 3 days with a bimodal distribution (1,2). 19.3% (n=11) of patients were discharged on PO day one. 1 patient from this cohort was readmitted within 30 days representing a 9.1% RR. From those patients discharged after day 1 (n=45), 5 were readmitted representing a 11.1% RR. All readmissions from both cohorts were managed at ward level.
Discussion
Our study shows that PO day one discharge of RAS CRC resection patients results in a decreased rate of 30 day readmissions compared to those discharged later than day one. It has not traditionally been the practice within our heath board to consider discharge within 24 hours of CRC resection. We hope this practice, as demonstrated in our robotic patients, can be considered and may help increase bed availability at our hospital and elsewhere.