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Review Article| Volume 143, ISSUE 2, P439-442, November 2016

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Feasibility and safety of same-day discharge after minimally invasive hysterectomy in gynecologic oncology: A systematic review of the literature

  • Samar Nahas
    Correspondence
    Corresponding author.
    Affiliations
    Department of Gynecologic Oncology, University of California Riverside, Gynecologic Oncology Department, 14350-2 Meridian Parkway, Riverside, CA 92518, United States
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  • Tomer Feigenberg
    Affiliations
    Department of Gynecology Oncology, University of Toronto, Trillium Health Partners, Credit Valley Hospital, 2200 Eglinton Ave W, Mississauga, ON L5M2N1, Canada
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  • Susan Park
    Affiliations
    Department of Gynecologic Oncology, University of California Riverside, Gynecologic Oncology Department, 14350-2 Meridian Parkway, Riverside, CA 92518, United States
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      Highlights

      • Compare same-day discharge (SDD) vs. traditional admission to the hospital following minimally invasive hysterectomy (MIS)
      • Six studies met eligibility criteria.
      • Results suggest that SDD post hysterectomy for gynecologic malignancies with or without staging is safe & feasible.
      • Low complication & readmissions rates, few/low rates of unscheduled visits within follow up period of 2–6 weeks after surgery

      Abstract

      Objective

      To compare same-day discharge (SDD) versus traditional admission to the hospital following minimally invasive hysterectomy (conventional laparoscopy and robotic assisted laparoscopy) for the treatment of gynecologic malignancies.

      Methods

      A systematic review was conducted in which MEDLINE and Cochrane Center Register of Controlled Trials were searched using terms related to same-day discharge, outpatient, and hysterectomy. We reviewed published English language trials and studies that compared safety, feasibility, readmission rate, emergency department (ED) visits, complication rate, and associated risk factors for admission. Studies of any design that included at least 20 patients who underwent minimally invasive hysterectomy (conventional laparoscopy and robotic laparoscopy) for gynecologic oncology indications were included.

      Results

      The literature review yielded 421 citations, of which 27 full-text articles were reviewed. Six comparative studies met eligibility criteria. Study data were abstracted and inputted into structural electronic forms.

      Conclusion

      Our results suggest that in comparison to admission post minimally invasive hysterectomy with or without full staging, SDD in gynecologic oncology procedures is safe, and feasible. It is associated with low complication and readmissions rates, few visits, and low rates of unscheduled visits within the follow up period of two to six weeks after surgery.

      Keywords

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