Remote monitoring after elective colorectal surgery, a pilot study.

Autor: Dornbush C; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA., Mishra A; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA., Hrabe J; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA., Guyton K; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA., Axelrod D; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA., Blum J; Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA., Gribovskaja-Rupp I; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA. Electronic address: irena-rupp@uiowa.edu.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2024 Sep 21. Date of Electronic Publication: 2024 Sep 21.
DOI: 10.1016/j.surg.2024.08.025
Abstrakt: Background: Multiple studies have demonstrated safety of short stay after colorectal resections. Remote patient monitoring may allow earlier discharge home after surgery. Remote patient monitoring feasibility after elective colorectal surgery in a largely rural state was evaluated.
Methods: A pilot study was undertaken May-August 2023 for patients >18 years of age, fluent in English, with compensated medical morbidities who underwent elective minimally invasive colorectal surgery. Patients were monitored at home with pulse oximetry, heart rate, blood pressure, and weight for 2 weeks. A remote nurse assessed and escalated to the colorectal surgery department as needed. Patients answered daily surveys on pain, ostomy/incision, bowel function, and oral intake. Patient satisfaction was surveyed on days 5 and 12 using a 5-point Likert scale.
Results: Sixteen patients undergoing laparoscopic colorectal surgery were enrolled preoperatively. The average length of stay was 3.0 days (1-9), 43% for malignancy, and 25% for inflammatory bowel disease. In 25% of cases, conversion to open surgery was required. The average home monitoring system set-up time was 53 minutes. Two patients were noncompliant. A third patient had a late loss of digital services. The remote nurse detected 2 complications: port site infection and delayed ileus. One required readmission. Patient satisfaction scores were high for the entire study period. Operation by third party failed in all attempted cases.
Conclusion: Remote home monitoring is a safe, feasible, and well-liked option for patients undergoing minimally invasive colorectal surgery in rural areas. Complex disease, compensated morbidities, and conversion to open surgery were not contraindications to early discharge.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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