The First 10 Days After Discharge: Timing and Causes of Unplanned Hospital Revisits Following Colorectal Cancer Surgery.

BackgroundDespite advances in laparoscopic techniques and widespread adoption of Enhanced Recovery After Surgery (ERAS) protocols, post-discharge readmission rates remain high following colorectal cancer surgery, driven especially by stoma-related complications. This study aimed to define the temporal distribution of unplanned hospital revisits and evaluate whether early, structured post-discharge surveillance can reduce these risks within a mature ERAS system.MethodsWe retrospectively enrolled 440 patients undergoing laparoscopic colorectal resection between 2019 and 2022. A Peri-discharge Quality Improvement (PQI) protocol was implemented, including standardized pre-discharge education and intensive follow-up: telephone assessment within 24 hours, specialist outpatient review on post-discharge day 3, and community follow-up on days 7 and 30. Patients managed under the PQI program were compared against national benchmark reference data derived from the National Surgical Quality Improvement Program (NSQIP) database, instead of a contemporaneous institutional control group.ResultsThe overall 30-day readmission rate was 7.7%, showing a non-significant downward trend compared with historical benchmarks. Notably, 83.0% of all unplanned hospital revisits occurred within the first 10 days after discharge. Targeted early surveillance was associated with lower stoma-related readmission rates relative to historical NSQIP benchmark controls (8.8% vs 19.0%; P = 0.028).ConclusionsThe first 10 days after discharge represent a critical high-risk window for unplanned hospital visits after colorectal cancer surgery. Implementation of the structured peri-discharge PQI program was associated with favorable stoma-related outcomes in elective colorectal surgery patients. Causal effects of the PQI and its superiority over usual care remain unproven.