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Comparing Discharge Timing in Patients Undergoing Immediate Implant-Based Breast Reconstruction: A Randomized

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Same day discharge (POD0) for mastectomy patients undergoing immediate implant-based breast reconstruction is safe and effective. This approach shows no significant difference in complications, patient-reported outcomes, or opioid use compared to one-day (POD1) discharge.

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Area of Science:

  • Oncology
  • Plastic Surgery
  • Surgical Outcomes

Background:

  • Enhanced Recovery After Surgery (ERAS) programs are increasingly implemented to improve patient recovery.
  • Same-day discharge (POD0) following mastectomy with immediate implant-based breast reconstruction has been suggested as a safe option.
  • ERAS programs aim to optimize perioperative care and patient outcomes.

Purpose of the Study:

  • To compare the outcomes of patients undergoing mastectomy with immediate implant-based breast reconstruction discharged on post-operative day zero (POD0) versus post-operative day one (POD1).
  • To evaluate complication rates, patient-reported outcomes (PROs), and opioid consumption between the two discharge groups.

Main Methods:

  • A randomized controlled trial was conducted with patients undergoing mastectomy and immediate implant-based breast reconstruction.
  • Patients were randomized to either POD0 or POD1 discharge.
  • Data collected included 30-day post-operative complications, PRO surveys, and opioid consumption (MME).

Main Results:

  • No significant differences in 30-day complication rates (e.g., seroma, flap necrosis) were observed between POD0 and POD1 discharge groups.
  • Emergency room visits, hospital admissions, and reoperation rates were similar between the two cohorts.
  • Patient-reported outcomes and post-operative opioid consumption (MME) showed no statistically significant differences.

Conclusions:

  • Discharge on post-operative day zero (POD0) is a safe and viable option for patients undergoing mastectomy with immediate implant-based breast reconstruction.
  • ERAS pathways can facilitate same-day discharge without compromising patient care quality, PROs, or increasing opioid use.
  • Optimizing ERAS protocols may allow for earlier discharge, improving patient flow and potentially reducing healthcare costs.