51 2 Mobile applications in gastrointestinal surgery: a systematic review Monitoring Almost half of the identified apps were used to monitor the clinical condition of patients who underwent gastrointestinal surgery.14-32 In general, the monitoring apps provided information about the operation, postoperative care, and self-management, contained daily assessments of the surgical wound (image uploading), symptoms and recovery progress, and some apps shared this information with the HCP. Six apps monitored patients after colorectal surgery. These apps had a completion rate of the daily assessments between 21 and 84%, and had good patient satisfaction.14-24 The app of Keng et al. had a 30-dayreadmission rate of 6% in comparison with a reported rate of 18% prior to the start of the cohort study.14 However, postoperative outcomes were not improved in a randomized controlled trial (RCT); only patient-reported outcomes did improve.15 In another RCT, it will be evaluated whether the app could prevent unplanned hospital visits.16 The app “Caresense” also had a communication feature. The app was evaluated in combination with the same-day discharge (SDD) protocol. The postoperative outcomes of patients using the app were comparable to patient without the app.17,18 The app was also evaluated in a retrospective study, in which the patient did not follow the SSD protocol. The app significantly decreased the rate of preventable emergency department visits.19 The app is available in the app stores, but not freely accessible. The app “Maela” was successfully tested on its feasibility and all post-discharge complications were detected by the app.20 The app is available in the app stores, but not freely accessible. The app of Symer et al. generated alerts for 26,7% of the patients and one patient within this group was readmitted.21 The app “MobiMD” was initially developed for several gastrointestinal procedures but its feasibility was successfully tested on mainly colorectal patients.22 The effect of the app on hospital readmissions will be evaluated in a RCT.23 The app “how2trak” is focused on surgical wound and symptom surveillance and its feasibility evaluation has not yet been completed.24 Two apps monitored patients after undergoing hepatopancreatobiliary surgery and both had a high reporting adherence.25-28 The “Interaktor” app was evaluated in a cohort, in which patients using the app reported significantly less symptoms and higher self-care activity rates compared to a historical control group.25-27 The app is available in the app stores. The already available “MyPlate” app monitored postoperative dietary intake and was used by the dietitian to guide patients during counseling visits. Caloric goals were achieved by 82.4% of the patients.28 Two apps monitored patients after upper gastrointestinal surgery and both were globally tested on their feasibility.29-31 The app “SurgeryDiary” had a high overall daily submission rate.29 The app “UDD” (Upper Digestive Disease) was indicated as a helpful tool for reporting and identifying problems, and enhanced communication with HCP. 30 However, the scoring of dumping-related symptoms and pain which was used in the app was not
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