Same-Day Discharge After Laparoscopic Hysterectomy for Endometrial Cancer

Abstract

Adoption of routine SDD after laparoscopic surgery for endometrial cancer and EIN did not result in increased complication rates within our institution. A larger prospective study is required to definitively establish the safety of this approach.

Systematic review of same‐day discharge after minimally invasive hysterectomy

“…A further 39 studies were excluded owing to full study texts being unavailable and 277 full-text articles were excluded after being reviewed for meeting the exclusion criteria. There were 15 articles 8,10,14,16,19,[24][25][26][27][28][29][30][31][32][33] included in the systematic review. It was not possible to perform stratified analyses between any minimally invasive surgical procedures and no randomized controlled trials were identified so no meta-analyses were performed.…”

“…Of the six prospective studies retrieved, 19 16,33 There were nine studies conducted in the USA, 8,10,14,16,[29][30][31][32][33] one in Canada, 26 and five in Europe. 19 In six studies, 19,24-28 it was prospectively planned that patients would undergo same-day discharge whereas there were nine studies 8,10,14,16,[29][30][31][32][33] where patients were retrospectively categorized as having undergone same-day discharge or having been hospitalized, depending on the length of stay recorded on patient charts. Several studies that were retrieved in the initial search were excluded owing to same-day discharge being defined as discharge within 24 hours of surgery; this definition made it impossible to differentiate between patients who were discharged either before or after midnight.…”

“…Attempts to minimize the risk of bias and to account for potential mental health disability, and mobility limitations ( Table 2). 24,26 There were five retrospective studies 8,10,14,30,32 that reported factors associated with significantly decreased odds of same-day discharge (Table 3); older age, 14,32 comorbidities, 14,32 and higher body mass index 32 were associated with decreased odds of same-day discharge. Factors identified as being associated with hospitalization rather than same-day discharge included beginning operations after 1:00-2:00 pm and completing operations after 6:00 pm.…”

Health Care Disparities in Hysterectomy for Gynecologic Cancers

“…[22][23][24][25][26][27][28][29][30][31][32] Key drivers of costs across all types of hysterectomy are length of hospital stay and operative time. 22 One avenue for further improvement is in further reducing length of stay, particularly because minimally invasive hysterectomy for uterine cancer is feasible as same-day discharges, 33 and in 2012, approximately 40% of patients were staying two or more nights in the hospital.…”

Robot‐assisted surgery in gynecological oncology: current status and controversies on patient benefits, cost and surgeon conditions – a systematic review

“…Regardless of these limitations, RAS seems to be associated with increased cost compared with the equivalent laparoscopic procedures although there is evidence that increased operative efficiency, in particular a decrease in procedure time, may reduce the overall costs (56). Many institutions routinely apply the potential for same day discharge, which could further decrease the costs in both RAS and CL (57).…”