Same-Day Discharge in Clinical Stage I Endometrial Cancer Patients Treated with Total Laparoscopic Hysterectomy, Bilateral Salpingo-Oophorectomy and Bilateral Pelvic Lymphadenectomy

Rettenmaier, Mark A.; Mendivil, Alberto A.; Brown, John V.; Abaid, Lisa N.; Micha, John P.; Goldstein, Bram H.

doi:10.1159/000337573

Cited by 25 publications

(13 citation statements)

References 44 publications

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“…Of the six prospective studies retrieved, four examined total laparoscopic hysterectomy, one included robotic‐assisted laparoscopic hysterectomy, and one included laparoscopic supra‐cervical hysterectomy. Among the nine retrospective studies, five included two or three procedures: total laparoscopic hysterectomy and robotic‐assisted laparoscopic hysterectomy (two studies), total laparoscopic hysterectomy and laparoscopic supra‐cervical hysterectomy (two studies), and total laparoscopic hysterectomy, laparoscopically assisted vaginal hysterectomy, and laparoscopic supra‐cervical hysterectomy (one study); three studies included robotic‐assisted laparoscopic hysterectomy only; and one study included total laparoscopic hysterectomy only (Table ).…”

Section: Resultsmentioning

confidence: 99%

Systematic review of same‐day discharge after minimally invasive hysterectomy

Korsholm

Mogensen

Jeppesen

et al. 2016

Intl J Gynecology & Obste

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Background: Same-day discharge has been suggested to safe and acceptable following minimally invasive hysterectomy. Objectives:To evaluate the feasibility of same-day discharge following minimally invasive hysterectomy and to identify associated factors. Search strategy: Medline, Embase and the Cochrane Central Register of ControlledTrials were systematically searched using the terms "same day discharge", "minimally invasive surgery", and "hysterectomy" between October 1 and October 31, 2015. No language or publication date restrictions were included.Selection criteria: Randomized controlled trials and observational studies evaluating same-day discharge before midnight on the day of minimally invasive hysterectomy were included.Data collection and analysis: Study characteristics, pre-operative selection criteria, and predictive factors for same-day discharge were analyzed.Main results: There were 15 observational studies with 11 992 patients included.Significant heterogeneity was observed in the studies, and publication and selection bias could have potentially affected the results. All the studies concluded that sameday discharge was feasible. However, some factors were associated with a decreased possibility of same-day discharge; these were older age, beginning surgery later than 1:00 pm and completing surgery later than 6:00 pm, longer duration of operation, and high estimated blood loss.Conclusions: Same-day discharge appears feasible for a majority of patients who undergo minimally invasive hysterectomies if adequate emphasis is placed on presurgical planning and careful patient selection.

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Section: Resultsmentioning

confidence: 99%

Systematic review of same‐day discharge after minimally invasive hysterectomy

Korsholm

Mogensen

Jeppesen

et al. 2016

Intl J Gynecology & Obste

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“…In our study, the complication rate was 0.9 %. In various studies conducted, Karaman et al [15] and Brummer et al [7] described a major complication rate of 1 and 1.8 %, respectively. In addition, Donnez described his retrospective study with 400 patients who underwent laparoscopic hysterectomy procedure, a major complication rate of 1.5 % [14].…”

Section: Discussionmentioning

confidence: 99%

“…Later gynecologic surgeons have made many efforts to improve the technique thereby shortening the learning curve and improve outcomes, reducing iatrogenic urinary-tract injuries, intraoperative blood loss [4], hospitalization time, and recovery time [5]. Now with the improvement of surgical skills, it has been considered with a day surgery hospital stay [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Hysterectomies: Our 10 Years Experience in a Single Laparoscopic Center

Bettaiah¹,

Reddy²

2015

J Obstet Gynecol India

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Study Objective To evaluate the association between outcomes of laparoscopic hysterectomy with respect to clinical factors, intraoperative variants, and post-operative complications. Design The study conducted was retrospective (Canadian Task Force Classification II-1). Setting The set used in this study was a gynecological laparoscopic centre. Patients The present study included 858 women who underwent laparoscopic hysterectomies with or without bilateral/unilateral salpingo-oophorectomy, from December 2004 to May 2014. Interventions Eight hundred and sixteen patients underwent total laparoscopic hysterectomy, 14 patients underwent subtotal laparoscopic hysterectomy, 20 patients underwent laparoscopic-assisted vaginal hysterectomy, and 8 patients underwent laparoscopic radical hysterectomy with bilateral pelvic lymph node dissection. Measurements and Main Results All surgeries were performed by the same surgeon, using the same surgical technique. The medical records were reviewed, and data were collected with respect to age, indications, type of surgery performed, intraoperative variants, and post-operative complications. Patient average age was 44.9 ± 6.2 years. Most common indication for benign TLH was leiomyoma of 54.4 %. Indications for laparoscopic radical hysterectomy were early stage endometrial cancer (n = 5) and early stage cervical cancer (n = 3). The maximum uterine size operated on was from 20-26 weeks, 4.9 % (n = 42). 9.7 % had previous abdominopelvic surgery. Fifty three % 123 underwent unilateral/bilateral salpingo-oophorectomy. Conversion rate was 0.93 % (n = 8). The minimum and maximum operating time during the total study period was 20 min-2 h. The major complication rates were 0.9 % (n = 8). The hospital stay was not more than 2 days. Conclusion In our experience of 858 laparoscopic hysterectomies, 850 were done for benign indications, and 8 done for malignancies. TLH can be performed more safely and under vision, with less blood loss, early post-operative recovery, less post-operative infection, and less complication rate.

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“…20 Rettenmaier and colleagues reported a series of 21 patients who were discharged home on the day of total laparoscopic hysterectomy with bilateral salpingooophorectomy and bilateral PLND dissection for endometrial cancer, and noted acceptable complication rates, concluding that SDD is feasible in the laparoscopic management of endometrial cancer. 19 More recently, Penner and colleagues found that SDD was feasible and safe in a series of 141 patients undergoing comprehensive staging for endometrial or cervical cancer. 21 Among 200 patients scheduled for robotic-assisted laparoscopic hysterectomy for a mixture of benign and malignant indications, Lee and colleagues found that 78 % of patients could be discharged home on the day of surgery, with acceptable rates of urgent care visits and readmission.…”

Section: Discussionmentioning

confidence: 99%

“…Several retrospective studies have suggested that despite older age and higher rates of comorbidities, perioperative morbidity and readmission rates after SDD are acceptably low in patients undergoing laparoscopic management of gynecologic cancers. [19][20][21][22] Gynecologic oncologists in our institution began implementing SDD for patients undergoing laparoscopic hysterectomy for endometrial cancer and EIN in 2011. In collaboration with a dedicated anesthesiologist, perioperative care protocols favoring SDD were developed, resulting in the broad adoption of SDD for patients undergoing laparoscopic management of these conditions.…”

mentioning

confidence: 99%