Feasibility of Same-Day Discharge in Patients Undergoing Laparoscopic Gynaecologic Oncology Surgery

To evaluate the safety and feasibility of same-day discharge (SDD) of oncology patients undergoing complex laparoscopic gynaecologic oncology surgery.

A retrospective review including patients from October 2019 to July 2023 undergoing surgical staging for endometrial, tubal, or cervical cancer, treatment for endometrial hyperplasia or pelvic masses. Surgeries included a total laparoscopic hysterectomy. Patients accomplishing SDD were compared with those requiring admission. Data collection included clinical, demographic, and perioperative variables up to 6 weeks after surgery. Univariate and multivariate analyses were conducted.

A total of 152 patients were included. On multivariate analysis, variables that significantly predicted admission were age ≥61 (OR 0.256; 95% CI 0.102-0.642, P = 0.004), BMI ≥30-34.9 kg/m² (OR 0.291; 95% CI 0.094-0.905), BMI ≥35 kg/m² (OR 0.207; 95% CI 0.075-0.569, P = 0.002), operative time ≥181 minutes (OR 0.143; 95% CI 0.057-0.361, P < 0.001), and an operative start time after 2:00 PM or later (OR .135; 95% CI 0.036-0.503, P = 0.003). Patient's location <1 hour away from the centre significantly increased the odds of SDD (OR 2.50; 95% CI 1.068-5.863, P = 0.035). Of 51 patients who accomplished SDD, there was a <4% failure rate, with those who were discharged requiring admission >96 hours postoperatively. The average length of stay was 1.09 days.

SDD is safe and feasible for patients. There are few complications, re-admissions, or unscheduled patient contacts postoperatively. Its success can be increased by refining patient selection using predictive variables.