Telemedicine interventions after colorectal surgery: A systematic review and meta-analysis.

完整摘要 · 英文原文

AIM: There has been increasing interest in telemedicine follow-up after surgery. This study aims to synthesize the literature regarding the effect of postoperative telemedicine after colorectal surgery on 30-day readmission and emergency department visit rates compared with usual care. METHOD: Relevant databases were searched until September 12, 2025. Two authors independently identified trials, extracted data, assessed risk of bias (ROB 2.0 and ROBINS-I), and evidence certainty (GRADE). Randomized controlled trials (RCTs) and controlled observational studies were included. Meta-analyses were conducted using random-effects models. Primary outcomes were 30-day readmissions and 30-day emergency department visits. Secondary outcomes included patient satisfaction and compliance with the telemedicine intervention. RESULTS: Thirteen studies (five RCTs, eight cohort studies) were included. Compared to usual care, telemedicine resulted in no difference in 30-day readmissions (odds ratio [OR]; 0.96; 95% CI: 0.69, 1.35, 11 studies, 7102 patients, low certainty) and 30-day emergency department visits (OR; 1.02; 95% CI: 0.67, 1.57, 8 studies, 6694 patients, low certainty). Evidence certainty was limited by serious imprecision and moderate to high risk of bias. Patient compliance with interventions ranged from 48.6% to 95.3% across studies. Patient satisfaction was higher for telemedicine compared to usual care (standardized mean difference; 0.88; 95% CI: 0.31, 1.45, 3 studies, 217 patients). CONCLUSION: Telemedicine interventions may lead to little difference in readmissions or emergency department visits after colorectal surgery. Telemedicine may improve patient satisfaction versus usual care. Evidence was of low certainty, indicating a need for larger randomized trials and high-quality observational studies with appropriate design and analysis to minimize confounding.