Major Ambulatory Surgery for the Treatment of Breast Cancer: Factors Conditioning Conversion to Conventional Hospitalization

Healthcare delivery to elderly and unfit patients with breast disease and comorbidities under an outpatient regime: A report of a personal surgical technique named “Cut&Sew”

“…Furthermore, the technique has been designed to overcome the lack of electrosurgical units and, therefore, to reduce the need for hemostasis, which in turn allows for the absence of any drainage, even for major procedures. All these factors positively impact the very short patient discharge (3 h after surgery) with no specific discharge recommendations to explain to the patient, unlike some day-surgery procedures [ 18 , 20 , [24] , [25] , [26] , [27] , [28] , 31 ].…”

“…Moreover, a stricter assessment of patient pain and overall satisfaction with the collection of a larger amount of reliable data could allow this technique to be extended to frail and/or older patients as a valuable and safe alternative to the more common hospitalization with general anesthesia. Indeed, outpatient surgery is predicted only when the patient is accurately prepared preoperatively and strictly controlled post-operatively [ 20 , 24 , 26 , [28] , [29] , [30] , [31] , 34 ].…”

“…Ambulatory surgery allows for the patient's discharge within 12 h, same-day surgery within 24 h, and non-ambulatory surgery involves at least a one-night stay in the hospital. Ambulatory surgery or same-day surgery is increasingly offered to patients [ 18 , [20] , [21] , [22] , [23] , [24] , [25] , [26] ] owing to the shorter monitoring time in the hospital and a decreased waiting time for surgery. The major benefit to the patient compared to the inpatient regime involves psychological distress and satisfaction [ 23 ], especially when major breast surgery and reconstruction need to be performed [ 26 ].…”

“…In our opinion, outpatient surgery represents a precious and safe alternative only when performed in a context in which the patient is accurately prepared preoperatively and strictly controlled post-operatively. However, ambulatory management has become the standard in many countries for the surgical treatment of BC [ 17 , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] ]. The monitoring duration in hospitals is shorter (less than 12 h) and allows for decreased cost and waiting time for surgical care.…”

Lipid changes during the perioperative period in patients with early breast cancer: a real-world retrospective analysis

“…Currently, complete surgery remains the major curative treatment for localized breast cancer [ 4 ]. However, surgery itself is also a trauma that might induce the stress response of patients to surgery [ 5 ].…”