Multiple factors affect same-day discharge (SDD) after laparoscopic surgery in gynecologic oncolo- gy, according to a study published in the Journal of Minimally Invasive Gynecology. Modifiable factors for SDD include the start time, surgeon preference, and patient expectations for SDD. Given these data, the investigators who conduct- ed the study suggest that centers prioritize surgical order by which patients are more likely to go home and that surgeons analyze their own data with re- spect to achieving higher SDD rates. During the study period, 800 minimally invasive procedures were performed with a 43.0% SDD rate. Patients who had SDD were younger (aged 52.3 vs 58.0), had a lower BMI (31.1 kg/m2 vs 33.7 kg/m2), were less likely to have a malignancy (28.2% vs 55.5%), had a lower estimated blood loss (EBL; 36 vs 72 mL), and were more likely to have re- ceived an enhanced recovery after surgery pro- tocol (49.8% vs 39.3%). Total surgical time was shorter in women with SDD (156 minutes vs 208 minutes), as was total narcotic use (23.1 mg morphine equivalents [MEq] vs 28.8 mg MEq). SDD was also associated with earlier start time. Laparoscopic cases were most likely to have SDD (51.4%) compared with robotic-assisted surgery (16.1%) or mini-laparotomy (10.5%). In a multi- variate analysis, the factors predicting SDD in order of predictive factors were surgical time, re- covery time, start time, surgeon, age, EBL, and surgery type.
- Business of Medicine
- Doctor’s Voice