Early discharge following transanal endoscopic microsurgery is safe.
OBJECTIVE
Transanal endoscopic microsurgery (TEM) was developed as an alternative to major surgery for rectal tumors; however, there is no consensus as to the optimal postoperative length of stay. The aim of this large series is to show that a policy of presumed early discharge is safe.


METHODS
All patients undergoing TEM at a single center between 2008 and 2011 were included. Data on demographics, tumor morphology, length of stay, and complications were collected from a prospectively collected database and computer records.


RESULTS
Sixty-six patients were included, with a mean tumor size of 4.6 cm (range, 0.6-10 cm). The majority were adenomas (71%). Median stay was 1 day, with most (77%) patients being discharged within the 23-hour policy. Neither age nor tumor size affected the length of stay. There were five complications (7.6%), and 2 patients (3%) required readmission following discharge. No complications arose in patients discharged within 23 hours.


CONCLUSIONS
The majority of patients were safely discharged within 23 hours. No early-discharge patient suffered complications or required readmission. The overall complication rate was consistent with other published series, and neither age nor tumor size adversely affected outcome. A routine 23-hour discharge policy can thus be recommended for TEM patients.
Department of Colorectal Surgery, Colchester General Hospital , Colchester, United Kingdom .
Christopher J
CJ
Wright
Matthew
M
Tutton
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D011351:Proctoscopy / Q000009:adverse effects / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome