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Same-Day Discharge After Laparoscopic Hysterectomy for Endometrial Cancer

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to investigate the relationship between same-day discharge (SDD) and postoperative complications within 30 days of laparoscopic hysterectomy for endometrial cancer and endometrial intraepithelial neoplasia (EIN).

Methods

This single-institution retrospective cohort included all patients who underwent conventional and robotic-assisted laparoscopic hysterectomy for endometrial cancer or EIN in a large teaching hospital between 2011 and 2013. Temporal trends in frequency of SDD and rates of postoperative complications were investigated to assess whether adoption of routine SDD was associated with increased postoperative complications. Associations between SDD and postoperative complications were also investigated in univariate and multivariate models.

Results

Overall, 696 patients underwent laparoscopic hysterectomy. Of these, 37.1 % had pelvic lymphadenectomy, 3.0 % had para-aortic lymphadenectomy, and 9.3 % underwent omentectomy. The rate of SDD increased from 3.9 to 69.6 % during the study period (p < 0.001), and the frequency of postoperative readmission, unscheduled surgery, infection, and composite complications within 30 days of hysterectomy did not differ during the study period. The composite complication rate did not differ significantly between patients who underwent surgery before and after the adoption of routine SDD (rate ratio 0.7, 95 % CI 0.4–1.2, p = 0.24). After controlling for demographic, intraoperative, and comorbid factors, patients who underwent SDD were not at increased risk for postoperative complications.

Conclusions

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.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Alexander Melamed MD, MPH, Jennifer L. Katz Eriksen MD, MSc & Emily M. Hinchcliff MD

  2. Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Boston, MA, USA

    Michael J. Worley Jr. MD, Ross S. Berkowitz MD, Neil S. Horowitz MD, Michael G. Muto MD & Colleen M. Feltmate MD

  3. Gynecologic Oncology Program, Susan F. Smith Center for Women’s Cancers, Dana–Farber Cancer Institute, Boston, MA, USA

    Ross S. Berkowitz MD, Neil S. Horowitz MD, Michael G. Muto MD & Colleen M. Feltmate MD

  4. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Richard D. Urman MD, MBA

Authors
  1. Alexander Melamed MD, MPH
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  2. Jennifer L. Katz Eriksen MD, MSc
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  3. Emily M. Hinchcliff MD
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  6. Neil S. Horowitz MD
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  8. Richard D. Urman MD, MBA
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Correspondence to Alexander Melamed MD, MPH.

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Melamed, A., Katz Eriksen, J.L., Hinchcliff, E.M. et al. Same-Day Discharge After Laparoscopic Hysterectomy for Endometrial Cancer. Ann Surg Oncol 23, 178–185 (2016). https://doi.org/10.1245/s10434-015-4582-4

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  • DOI: https://doi.org/10.1245/s10434-015-4582-4

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