Background: Sleeve gastrectomy (SG), with its short operating time, is possible to perform as same-day surgery, with the most common reason for requiring overnight hospital stay being post-operative nausea and vomiting. Objective: To demonstrate the feasibility and safety of SG as same-day surgery with regards to complication rate. Additionally, the study aimed to evaluate factors determining the duration of hospital stay, such as type of anesthesia, time of procedure, degree of postoperative nausea and pain, American Society of Anesthesiologists (ASA) score or previous abdominal surgery. Setting: Non-academic primary referral center. Method: A sub-study of a single-center, double blind, randomized controlled trial. Patients included in this study underwent SG and were randomized into one of the two types of anesthesia; Total intravenous anesthesia (TIVA) with propofol, or desflurane. Primary endpoint was the number of patients discharged the same day as surgery. Secondary endpoints were unplanned telephone calls, readmission rate and complication rate. Time of procedure was registered by the staff at the operation theatre. Visual analogue scales (VAS) score estimating patients' intensity of pain and nausea were completed at the postoperative (PO) unit, surgical ward, and 24-48 hours post-operatively. Results: Ninety-three patients were included in the study. Fifty-nine (63%) were discharged the same day as surgery (32 desflurane and 27 TIVA), 30 patients (32%) were discharged one 2 day following surgery, and four patients (4%) were discharged after more than two days (15 desflurane and 19 TIVA). The most common reasons for prolonged stay were pain, nausea and fatigue. Statistical analyses showed no association between day of discharge and the type of anesthesia, time of the procedure, degree of postoperative nausea and vomiting (PONV), pain intensity, ASA score, or previous abdominal surgery. Conclusion: Same-day surgery is feasible and safe in terms of low complication rate. The type of anesthesia, time of procedure, degree of PONV and pain, ASA score and previous abdominal surgery does not appear to affect length of hospital stay.
