Loop Ileostomy Closure as an Overnight Procedure: Institutional Comparison With the National Surgical Quality Improvement Project Data Set

BACKGROUND: Enhanced recovery pathways have decreased length of stay after colorectal surgery. Loop ileostomy closure remains a challenge, because patients experience high readmission rates, and validation of enhanced recovery pathways has not been demonstrated. This study examined a protocol whereby patients were discharged on the first postoperative day and instructed to advance their diet at home with close telephone follow-up. OBJECTIVE: The hypothesis was that patients can be safely discharged the day after loop closure, leading to shorter length of stay without increased rates of readmission or complications. DESIGN: Patients undergoing loop ileostomy closure were queried from the American College of Surgeons National Surgical Quality Improvement Project and compared with a single institution (2012–2015). Length of stay, 30-day readmission, and 30-day morbidity data were analyzed. SETTINGS: The study was conducted at a tertiary university department. PATIENTS: The study includes 1602 patients: 1517 from the National Surgical Quality Improvement Project database and 85 from a single institution. MAIN OUTCOME MEASURES: Length of stay and readmission rates were measured. RESULTS: Median length of stay was less at the single institution compared with control (2 vs 4 d; p

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