EP805 - Very Early Discharge After Colorectal Major Surgery Beyond ERAS Protocols: Case Series and Feasibility analysis

ePoster Presenter(s)

• 

  fabrizio vittadello, Expertise in minivasive colorectal surgery (he/him/his)

  Senior consultant
  Azienda Ospedale Universita Padova
  Azienda Ospedale Università Padova
  Padova, Veneto, Italy

  All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

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Author(s)

• AF

  Alvise Frasson, MD, PhD

  Senior Consultant
  AOUP - Azienda Ospedaliera Università di Padova
  Padova, Veneto, Italy

  Disclosure information not submitted.

Author(s)

• 

  Nicola Passuello, MD (he/him/his)

  Senior Consultant in General Surgery
  OSA General Surgery - Padua University Hospital
  Padua University
  PADOVA, Veneto, Italy

  Disclosure information not submitted.

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Author(s)

• EM

  Enzo Mammano, n/a

  Senior Consultant
  OSA General Surgery - Padua University Hospital
  Padova, Veneto, Italy

  Disclosure information not submitted.
• LF

  Luca Faccio, n/a

  Medico strutturato
  Azienda Ospedale Università Padova
  PADOVA, Veneto, Italy

  Disclosure information not submitted.
• DS

  Daniele Sandonà, n/a

  General Surgery Resident
  OSA General Surgery, Padua University Hospital, 35128 Padua, Italy
  Padova, Veneto, Italy

  Disclosure information not submitted.
• AP

  Alice Pecorino, n/a

  Medical doctor
  University of Padua
  Padova, Veneto, Italy

  Disclosure information not submitted.
• ET

  Emanuela Tessari, n/a

  Senior Consultant
  OSA General Surgery - Padua University Hospital
  Padova, Veneto, Italy

  Disclosure information not submitted.

Senior Author(s)

• GS

  Giacomo Sarzo, n/a

  OSA General Surgery Chief Physician
  OSA General Surgery, Padua University Hospital, 35128 Padua, Italy
  Padova, Veneto, Italy

  Disclosure information not submitted.

Purpose/Background: Early discharge after colorectal surgery is a widespread practice within Enhanced Recovery After Surgery (ERAS) protocols. However, full adherence to ERAS protocols is not always feasible in all clinical contexts. Early discharge can yield significant economic benefits. This preliminary study explores safety and feasibility of discharge within the third postoperative day (POD-3) in patients undergoing minimally invasive colorectal major surgery, without full ERAS compliance.

Methods/Interventions: Data were collected from patients who underwent minimally invasive colorectal major surgery between January and August 2025 and were discharged on postoperative day (POD) 3. Clinical and surgical variables were analyzed, including age, sex, American Society of Anesthesiology physical status classification system (ASA score), Charlson Comorbidity Index (CCI), body mass index (BMI), smoking status, type and duration of surgery, surgeon's experience, time to flatus and oral intake, C-reactive protein (CRP) levels at POD-3, adverse events at 30 days, and Clavien-Dindo classification.

Results/Outcomes: The study involved 23 patients (17 females and 6 males) out of a total of 84 who underwent elective major colorectal surgery for benign or malignant conditions. The median age was 72 years, with a median ASA score of 2 and a median Charlson Comorbidity Index (CCI) of 3. All surgical procedures were performed using minimally invasive techniques (19 laparoscopic and 4 robotic surgeries). The average operative time was around 160 minutes. No major complications were reported during follow-ups at 7 and 30 days.

Conclusion/Discussion: In selected patients, discharge within POD-3 following minimally invasive colorectal major surgery appears safe and feasible, even without full adherence to ERAS protocols. Incorporating good clinical practices and monitoring biomarkers such as CRP can effectively guide discharge decisions. Broader adoption of such practices may optimize institutional resource allocation, particularly where complete ERAS implementation is not possible. Further studies with larger cohorts are needed to validate these findings.

Table 1
The patients involved most relevant variables