Same-day discharge after robotic surgery for endometrial cancer.

Autor: Zhang N; Department of Obstetrics and Gynecology, The University of Tennessee Health Science Center, Memphis, TN, USA., Wilson B; Division of Gynecologic Oncology, West Cancer Center and Research Institute, 7945 Wolf River Blvd., Memphis, TN, 38138, USA., Enty MA; Department of Obstetrics and Gynecology, The University of Tennessee Health Science Center, Memphis, TN, USA., Ketch P; Department of Obstetrics and Gynecology, The University of Tennessee Health Science Center, Memphis, TN, USA., Ulm MA; Division of Gynecologic Oncology, West Cancer Center and Research Institute, 7945 Wolf River Blvd., Memphis, TN, 38138, USA., ElNaggar AC; Division of Gynecologic Oncology, West Cancer Center and Research Institute, 7945 Wolf River Blvd., Memphis, TN, 38138, USA., Daily L; Division of Gynecologic Oncology, West Cancer Center and Research Institute, 7945 Wolf River Blvd., Memphis, TN, 38138, USA., Tillmanns T; Division of Gynecologic Oncology, West Cancer Center and Research Institute, 7945 Wolf River Blvd., Memphis, TN, 38138, USA. ttillmanns@westclinic.com.
Jazyk: angličtina
Zdroj: Journal of robotic surgery [J Robot Surg] 2022 Jun; Vol. 16 (3), pp. 543-548. Date of Electronic Publication: 2021 Jul 08.
DOI: 10.1007/s11701-021-01253-0
Abstrakt: To assess the safety of same-day discharge (SDD) following robotic-assisted endometrial cancer staging and identify risk factors for postoperative admission in a diverse population. A review of patients who underwent robotic-assisted endometrial cancer staging from April 1, 2017 to April 1, 2019 was performed. Patients were evaluated for SDD if they met the following criteria: tolerating oral intake, voiding spontaneously, ambulating, negative orthostatic vitals, postoperative hemoglobin ≤ 2 g/dL from baseline, pain controlled on oral medications, and desire to be discharged. Risk factors for admission were identified. One hundred eighty-seven patients were identified. SDD criteria were met in 158, of which 132 (83.5%) were discharged same day. Median length of stay was 4.5 h. Reasons for admission despite meeting criteria were late surgery time (n = 15), abnormal vitals (n = 9), and personal concerns (n = 2), with risk factors being age ≥ 68 years (OR 2.72; 95% CI, 1.13-6.59), start time 1400 or later (OR = 11.25; 95% CI, 4.35-29.10), ASA ≥ 4 (OR 23.82; 95% CI, 2.54-223.15), history of CVA/MI (OR 5.61; 95% CI, 1.07-29.52), and operative time ≥ 120 min (OR = 3.83; 95% CI 1.36-10.77). Of the SDD cohort, 2 patients (1.3%) presented to the emergency room within 30 days (postoperative day 5 and 23). SDD following robotic-assisted endometrial cancer staging is safe and feasible. Age ≥ 68 years, surgery start time after 1400, ASA ≥ 4, history of CVA/MI, and operative time ≥ 120 min appear predictive of inpatient admission despite meeting SDD criteria.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Databáze: MEDLINE
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