The safety of same-day discharge after laparoscopic hysterectomy for endometrial cancer

To determine factors influencing discharge patterns after laparoscopic hysterectomy for endometrial cancer and to evaluate the safety of same-day discharge during the 30-day postoperative period. Using the American College of Surgeons' National Surgical Quality Improvement Project's databa...

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Vydané v:Gynecologic oncology Ročník 142; číslo 3; s. 508 - 513
Hlavní autori: Lee, Jessica, Aphinyanaphongs, Yindalon, Curtin, John P., Chern, Jing-Yi, Frey, Melissa K., Boyd, Leslie R.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Elsevier Inc 01.09.2016
Predmet:
Ambulatory Surgical Procedures - adverse effects
Ambulatory Surgical Procedures - methods
Ambulatory Surgical Procedures - statistics & numerical data
Endometrial cancer
Endometrial Neoplasms - epidemiology
Endometrial Neoplasms - surgery
Female
Hematology, Oncology and Palliative Medicine
Hospital admission
Humans
Hysterectomy - adverse effects
Hysterectomy - methods
Hysterectomy - statistics & numerical data
Laparoscopic hysterectomy
Laparoscopy - adverse effects
Laparoscopy - methods
Laparoscopy - statistics & numerical data
Middle Aged
Minimally invasive
Obstetrics and Gynecology
Same-day discharge
United States - epidemiology
Endometrial cancer
Laparoscopic hysterectomy
Same-day discharge
Hospital admission
Minimally invasive
ISSN:0090-8258, 1095-6859
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Shrnutí:To determine factors influencing discharge patterns after laparoscopic hysterectomy for endometrial cancer and to evaluate the safety of same-day discharge during the 30-day postoperative period. Using the American College of Surgeons' National Surgical Quality Improvement Project's database, patients who underwent hysterectomy for endometrial cancer from 2010 to 2014 were identified and categorized by their hospital length of stay. Statistical analyses were performed to assess the relationship between hospital stay and demographics, medical comorbidities, intraoperative surgical factors and postoperative outcomes. A total of 9020 patients had laparoscopic hysterectomies for endometrial cancer and of these, 729 patients (8.1%) were successfully discharged on the day of surgery. These patients were younger and had lower body mass indexes and fewer medical comorbidities than patients who were admitted after their procedure. The same-day discharge group underwent surgical procedures of less complexity than the hospital admission group based on shorter operative times and fewer relative value units (RVUs). There was a lower rate of surgical site infections in the same-day discharge group, and no difference in rates of other postoperative complications including hospital readmissions and reoperations. Rates of laparoscopic hysterectomy for endometrial cancer are gradually increasing but the rates of same-day discharge have increased at a much slower rate. Same-day discharge has been successful despite differences in preoperative demographics, medical comorbidities and intraoperative surgical complexity. Overall postoperative complication rates were equivalent despite length of hospital stay, demonstrating the safety and feasibility of same-day discharge after laparoscopic hysterectomy for endometrial cancer. •Few patients undergo same-day discharge after laparoscopic hysterectomy for endometrial cancer in the United States.•Same day discharge patients are younger, and have fewer medical comorbidities than patients admitted to the hospital.•There was no difference in postoperative complications between same-day discharge patients and admitted patients.
Bibliografia:ObjectType-Article-1
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ISSN:0090-8258
1095-6859
DOI:10.1016/j.ygyno.2016.06.010