Related Experiment Video
Updated: Aug 6, 2026
Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
Published on: November 25, 2025
Safety and Health Economic Benefits of Primary Palatoplasty With the Day Surgery Pathway: A Retrospective Study
Huilin Wang1, Jie Tao2, Xuefei Pang1
1Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
Insights
Day surgery for primary palatoplasty is safe and effective for low-risk patients. This approach reduces hospital stays and costs while adhering to enhanced recovery principles.
Area of Science:
- Cleft Palate Surgery
- Pediatric Surgery
- Day Surgery Protocols
Background:
- Primary palatoplasty is a common surgical procedure for cleft palate.
- Traditional inpatient settings may lead to prolonged hospital stays and increased costs.
Purpose of the Study:
- To evaluate a day surgery protocol for primary palatoplasty.
- To assess the safety, efficacy, and health economic impact of day surgery compared to inpatient care.
Main Methods:
- Retrospective study of 748 patients undergoing primary palatoplasty (374 in day surgery, 374 in inpatient).
- 1:1 propensity score matching based on key patient characteristics.
- Comparison of surgical outcomes, postoperative complications, and health economic indicators.
Main Results:
- Day surgery group had shorter operative, anesthesia, and PACU discharge times.
- No significant differences in blood loss, overall complications, or readmission/reoperation rates.
- Day surgery resulted in significantly shorter length of stay and reduced hospitalization costs (70.7% of inpatient costs).
Conclusions:
- A mature day surgery protocol for primary palatoplasty is safe and effective for low-risk patients.
- Day surgery significantly reduces hospital stay duration and healthcare costs.
- This approach aligns with enhanced recovery after surgery (ERAS) principles.
Objectives:
To present a day surgery protocol for primary palatoplasty and assess its safety and efficacy through surgical outcomes and health economic indicators.
Methods:
A single-center retrospective study was conducted at Shanghai Ninth People's Hospital between January 2018 and August 2025, screening patients undergoing primary palatoplasty. A 1:1 propensity score matching was performed for sex, age, cleft palate classification, and American Society of Anesthesiologists grade from the day surgery group and the inpatient group. Postoperative outcomes, medication utilization patterns, and health economic indicators were compared.
Results:
Each cohort included 374 patients. Baseline characteristics were well-balanced after matching (all P>0.05). The day surgery group exhibited significantly shorter operative time (50 versus 50 min, P=0.025), anesthesia time (70 versus 75 min, P<0.001), and Post-Anesthesia Care Unit discharge time (80 versus 90 min, P<0.001). No significant between-group differences were observed in intraoperative blood loss, overall complications, 30-day readmission or reoperation rates (P>0.05), and no severe complication was reported. One patient in the day surgery group developed postoperative upper airway edema requiring an extended hospital stay for 1 additional day. The day surgery group had a shorter length of stay (24 versus 119.05 h, P<0.001) and reduced total hospitalization costs (median 70.7% of the inpatient group's costs, P<0.001).
Conclusions:
For low-risk cleft palate patients, surgery performed under a mature protocol at a day surgery ward is safe, shortens hospital stays, reduces costs, and aligns with enhanced recovery after surgery principles.
