Same-day colectomy safety for selected patients undergoing robotic colorectal surgery.

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a prospective cohort at a single academic center following patients selected for outpatient robotic-assisted colorectal operations to record early postoperative outcomes. Eligible patients are adults with good functional capacity and controlled chronic conditions who have a responsible caregiver and access to phone/computer at home. Perioperative requirements include stopping certain antiplatelet drugs before surgery, completion of pre/postoperative education, and same-day discharge with planned clinic follow-up. The study tracks complications, emergency visits, readmissions, and recovery measures to determine whether same-day colectomy is a viable option for a select group of patients.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Ages 18-70
* Undergoing robotic-assisted right colectomy, sigmoidectomy, or low anterior resection.
* Able to perform greater than 4 metabolic equivalents (METS) without shortness of breath
* Must have a designated adult who can care for them at home postoperatively until their in-person clinic visit
* Access to a cell phone or computer and running water.
* Successfully completed pre-operative and post-operative education
* Medical criteria:
* Well controlled hypertension with systolic blood pressure \< 140 controlled by less than two medications which they are compliant with
* Well controlled diabetes on oral agents only with blood glucose level \< 180 on daily checks
* Anti-platelet agents including aspirin, clopidogrel, prasugrel, ticagrelor or ticlopidine will be stopped 7 days preoperatively and restarted on postoperative day 1. See exclusion criteria 7 for specific exclusion criteria regarding antiplatelet agents.

Exclusion Criteria:

* Medical criteria:
* Neurocognitive deficits not allowing for adequate preoperative education
* Congestive heart failure with EF \< 45%
* Symptomatic aortic stenosis causing heart failure, syncope, dyspnea or angina
* Pulmonary fibrosis or pulmonary hypertension
* COPD or home oxygen use \> 2L
* Chronic kidney disease of any stage.
* Lack of a caregiver at home or functionally bed-bound
* Ultralow pelvic resection
* Need for ostomy creation intraoperatively
* Operative time greater than 5 hours as this likely indicates a complex case and dissection necessitating closer monitoring in the hospital
* Conversion to open procedure intraoperatively
* Patients receiving antiplatelet agents such as clopidogrel, prasugrel, ticagrelor or ticlopidine within one year of coronary or carotid stent implantation, TAVR or LAAO placement.
* Patients on therapeutic anticoagulation medications such as warfarin, Eliquis, Xarelto, Enoxaparin
* Current tobacco use
* Patients who were unable to complete preoperative education, do not feel comfortable with care at home, or do not have an available caregiver for the first 7 postoperative days
* Any surgical history that would preclude safe abdominal entry for robotic surgery

Where it's running

• Banner University Medical Center Phoenix
  Phoenix, Arizona, United States Recruiting

Study contacts

• Principal investigator: Eugene Kim, MD — University of Arizona

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.