Early Discharge Following Transanal Endoscopic Microsurgery Is Safe

Aim: 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. Patients and 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.