Design: Systematic review and meta-analysis of 5 RCTs and 8 cohort studies
Population: Patients after colorectal surgery; 7,102 in the readmission analysis
Primary outcome: 30-day readmission and 30-day emergency department visits
Effect: Readmission OR 0.96 (95% CI 0.69 to 1.35); emergency visits OR 1.02 (0.67 to 1.57); low certainty

This systematic review pooled 13 studies (five randomised trials and eight cohorts) comparing telemedicine follow-up with usual care after colorectal surgery. Risk of bias and certainty were graded.

Thirty-day readmission was similar (odds ratio 0.96, 95% CI 0.69 to 1.35; 11 studies, 7,102 patients) and so were emergency department visits (OR 1.02, 0.67 to 1.57; 8 studies, 6,694 patients). Both were low-certainty. Compliance with the interventions ranged from 48.6% to 95.3%. Satisfaction favoured telemedicine (standardised mean difference 0.88, 0.31 to 1.45; three studies, 217 patients).

The intervals are wide enough to include both a meaningful reduction and an increase in events. Telemedicine is reasonable where distance or capacity is the problem, as in many Indian referral centres, but this review does not show that it prevents readmissions.

Telemedicine follow-up did not clearly reduce readmissions or emergency visits.
It may suit patients who live far from the unit, with a clear plan for when to attend in person.
Give explicit red-flag advice: fever, wound change, vomiting, stoma output.
Expect variable uptake; compliance was as low as about half in some studies.

Why it matters

Telemedicine is often adopted on the assumption that it avoids returns to hospital, and the pooled data do not show that.

The statistics, in plain English

An odds ratio near 1 with an interval of 0.69 to 1.35 means no clear difference, but it cannot exclude a 30% reduction or a 35% rise in odds. 'Low certainty' means further studies could change the answer.