Early Discharge After Colorectal Surgery

RECUPERA-C is a prospective observational cohort study conducted within an established Enhanced Recovery After Surgery (ERAS) program. The study will include adult patients undergoing elective major colorectal surgery through a minimally invasive approach.

The study will evaluate a structured early discharge protocol based on predefined clinical and functional criteria. Patients will be assessed during the first 48 hours after surgery to determine whether they meet the conditions considered necessary for safe discharge. These criteria include clinical stability, adequate pain and nausea control, oral intake, gastrointestinal recovery, and functional recovery.

Patients will be followed prospectively for 30 days after surgery. The study will evaluate the proportion of patients meeting the early discharge criteria, the actual early discharge rate, reasons for prolonged hospitalisation, total length of stay, postoperative complications, readmissions, healthcare resource utilisation, and patient satisfaction.

C-reactive protein and neutrophil-to-lymphocyte ratio will be collected as exploratory biomarkers to assess their potential association with postoperative complications and their possible role as complementary tools for risk stratification.

The study will also identify clinical, functional, social, and organisational factors that may limit implementation of the early discharge strategy. The overall aim is to determine whether a structured discharge pathway within an ERAS programme can safely and feasibly reduce hospital stay to 48 hours or less after minimally invasive colorectal surgery.

Inclusion criteria

• Age ≥18 years.
• Elective major colorectal surgery for benign or malignant disease.
• Minimally invasive approach (laparoscopic or robotic).
• ASA physical status I-III.
• Functional independence in basic activities of daily living.
• Adequate home support and the ability to access and return to the hospital if required.
• Adequate understanding of the perioperative plan.
• Written informed consent.

Exclusion criteria

• Emergency surgery.
• Significant intraoperative complications.
• Major multivisceral resections.
• New ostomy creation.
• Functional dependence or significant cognitive impairment.
• Decompensation of major comorbidities.
• Anticipated need for postoperative admission to an intensive care unit.
• Social circumstances that may make early discharge unsafe.