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Same-day Discharge after Robotic Hysterectomy for Benign Conditions: Feasibility and Safety
Samer Tannus1, Andrea Giannini1, Javier F Magrina1
1Department of Medical and Surgical Gynecology, Mayo Clinic (Drs. Tannus, Giannini, and Magrina; Ms. Crosson, and Drs. Yi and Butler), Phoenix, Arizona.
Study Objective:
To investigate the feasibility and predictive factors for same-day discharge (SDD) after robotic hysterectomy (RH) for benign indications to optimize patient selection by incorporating preoperative, intraoperative, and postoperative variables.
Design:
A single-center retrospective cohort study.
Setting:
Tertiary academic hospital.
Patients:
Patients undergoing RH for benign indications.
Interventions:
Patients were designated for SDD by implementing enhanced recovery after surgery protocol.
Measurements And Main Results:
The study included 890 patients who underwent RH for benign indications between the years 2016 and 2021. Of these, 618 (69.4%) were discharged the same day and 272 (30.5%) were admitted for overnight stay. Both groups had similar age (46.4 vs 46.2 years), body mass index (28.3 vs 28.9), and indications for surgery. In multivariable logistic regression, factors that were significant for overnight stay were American Society of Anesthesiologists score 3, Charlson comorbidity index, previous laparotomy, and operative time. Other factors such as surgery start time and preoperative hemoglobin levels were not statistically significant. Postoperative outcomes were comparable for both groups with similar readmission and reoperation rates.
Conclusion:
The likelihood of SDD after RH in this cohort after implementing enhanced recovery after surgery protocol was almost 70%, and most of the predictive factors for overnight stay were nonmodifiable. Importantly, both groups had similar outcomes after surgery.
