SRS163 - Evaluating a postoperative colorectal virtual hospital pathway at west hertfordshire teaching hospitals NHS trust

Abstract Introduction Virtual Hospital (VH) pathways have been introduced to deliver home-based care through remote monitoring. Their use in elective colorectal surgery remains limited due to safety concerns and lack of evidence. This pilot study evaluated the safety, feasibility, and experience of a VH pathway following elective colorectal surgery. Methods A retrospective analysis was performed at West Hertfordshire Teaching Hospitals NHS Trust (Nov 2023–Mar 2025). Patients meeting strict perioperative criteria were enrolled. Primary outcomes were inpatient length of stay (IPLOS), VH length of stay (VHLOS), and 30-day readmission. Secondary outcomes included complications, Clavien-Dindo ≥II morbidity, anastomotic leak, unplanned ICU admission, and patient-reported experience. For colorectal cancer, propensity score matching (age, sex, BMI, ASA, CCI, CR-POSSUM, TNM, operation type) compared VH with pre-VH cohorts. Results Of 367 patients, the overall median IPLOS was 4 days with 14.1% 30-day-readmission. The VH subgroup (n = 81) had IPLOS 2 days, VHLOS 3 days, and 7.0% 30-day-readmission. Stoma reversals (n = 28) had IPLOS 1 day and 14.3% 30-day-readmission; resections (n = 53) had IPLOS 2 days and 3.3% 30-day-readmission. Non-VH patients (n = 286) had IPLOS 5 days and 16.1% 30-day-readmission. In matched cancer patients (43 VH versus 43 pre-VH), IPLOS was significantly shorter (1.7 versus 6.2 days, P < 0.001) with no increase in complications, anastomotic leak, ICU admission, or readmission. Patient surveys (n = 33, 41%) reported satisfaction scores 8.5–8.8/10; >90% valued monitoring and 95% preferred VH to inpatient care. Conclusions A postoperative VH pathway is feasible, safe, patient-centred and reduces hospital stay. Further multicentre trials should assess cost-effectiveness and long-term safety.