Objectives: The purpose of this retrospective study was to evaluate the capacity for same-day discharge in clinical stage I endometrial cancer (EC) patients treated with total laparoscopic hysterectomy (TLH), bilateral salpingo-oophorectomy (BSO) and bilateral pelvic lymph node dissection (BPLND). Methods: We retrospectively reviewed the charts of stage I EC patients who were treated with TLH, BSO and BPLND and discharged on the same day. The intra- and postoperative clinical variables (e.g., age, complications, surgery time, patient hospital stay) were evaluated in an attempt to discern which factors may predispose a patient to same-day discharge. Results: Twenty-one patients were successfully discharged on the same day of surgery. Mean operative time was 1.48 h and length of hospital stay was 6.35 h. There were no intraoperative complications or hospital readmissions. Conclusions: We present a single, institutional experience solely assessing the capacity for same-day discharge in clinical stage I EC patients treated with TLH, BSO and BPLND. Since the postoperative complication rate was minimal with no hospital readmissions, we suggest that particularly selected stage I EC patients are amenable to outpatient management.

Keywords:
Endometrial carcinoma, Surgery, Same-day discharge
1.
Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ: Cancer statistics, 2009. CA Cancer J Clin 2009;59:225–249.
2.
Smith DC, Macdonald OK, Lee CM, Gaffney DK: Survival impact of lymph node dissection in endometrial adenocarcinoma: a surveillance, epidemiology, and end results analysis. Int J Gynecol Cancer 2008;18:255–261.
3.
Gaia G, Holloway RW, Santoro L, Ahmad S, Di Silverio E, Spinillo A: Robotic-assisted hysterectomy for endometrial cancer compared with traditional laparoscopic and laparotomy approaches: a systematic review. Obstet Gynecol 2010;116:1422–1431.
4.
Zullo F, Palomba S, Falbo A, Russo T, Mocciaro R, Tartaglia E, et al: Laparoscopic surgery vs laparotomy for early stage endometrial cancer: long-term data of a randomized controlled trial. Am J Obstet Gynecol 2009;200:296.e1–e9.
5.
Ghezzi F, Cromi A, Uccella S, Siesto G, Giudici S, Serati M, et al: Laparoscopic versus open surgery for endometrial cancer: a minimum 3-year follow-up study. Ann Surg Oncol 2010;17:271–278.
6.
Janda M, Gebski V, Brand A, Hogg R, Jobling TW, Land R, et al: Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): a randomised trial. Lancet Oncol 2010;11:772–780.
7.
Mourits MJ, Bijen CB, Arts HJ, ter Brugge HG, van der Sijde R, Paulsen L, et al: Safety of laparoscopy versus laparotomy in early-stage endometrial cancer: a randomised trial. Lancet Oncol 2010;11:763–771.
8.
Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, et al: Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol 2009;27:5331–5336.
9.
Gien LT, Kupets R, Covens A: Feasibility of same-day discharge after laparoscopic surgery in gynecologic oncology. Gynecol Oncol 2011;121:339–343.
10.
Summitt RL Jr, Stovall TG, Lipscomb GH, Ling FW: Randomized comparison of laparoscopy-assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting. Obstet Gynecol 1992;80:895–901.
11.
Chou DC, Rosen DM, Cario GM, Carlton MA, Lam AM, Chapman M, Johns C: Home within 24 h of laparoscopic hysterectomy. Aust N Z J Obstet Gynaecol 1999;39:234–238.
12.
Thiel J, Gamelin A: Outpatient total laparoscopic hysterectomy. J Am Assoc Gynecol Laparosc 2003;10:481–483.
13.
de Lapasse C, Rabischong B, Bolandard F, Canis M, Botchorischvili R, Jardon K, Mage G: Total laparoscopic hysterectomy and early discharge: satisfaction and feasibility study. J Minim Invasive Gynecol 2008;15:20–25.
14.
Hoffman CP, Kennedy J, Borschel L, Burchette R, Kidd A: Laparoscopic hysterectomy: the Kaiser Permanente San Diego experience. J Minim Invasive Gynecol 2005;12:16–24.
15.
Perron-Burdick M, Yamamoto M, Zaritsky E: Same-day discharge after laparoscopic hysterectomy. Obstet Gynecol 2011;117:1136–1141.
16.
Chou YJ, Ou YC, Lan KC, Jawan B, Chang SY, Kung FT: Preemptive analgesia installation during gynecologic laparoscopy: a randomized trial. J Minim Invasive Gynecol 2005;12:330–335.
17.
Fagotti A, Bottoni C, Vizzielli G, Alletti SG, Scambia G, Marana E, et al: Postoperative pain after conventional laparoscopy and laparoendoscopic single site surgery (LESS) for benign adnexal disease: a randomized trial. Fertil Steril 2011;96:255–259.
18.
McClellan SN, Hamilton B, Rettenmaier MA, Lopez K, John CR, Hu JC, et al: Individual physician experience with laparoscopic supracervical hysterectomy in a single outpatient setting. Surg Innov 2007;14:102–106.
19.
Pecorelli S.Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet 2009;105:103–104.
20.
Camanni M, Bonino L, Delpiano EM, Migliaretti G, Berchialla P, Deltetto F: Laparoscopy and body mass index: feasibility and outcome in obese patients treated for gynecologic diseases. J Minim Invasive Gynecol 2010;17:576–582.
21.
von Gruenigen VE, Tian C, Frasure H, Waggoner S, Keys H, Barakat RR: Treatment effects, disease recurrence, and survival in obese women with early endometrial carcinoma: a Gynecologic Oncology Group study. Cancer 2006;107:2786–2791.
22.
Jung YW, Lee M, Yim GW, Lee SH, Paek JH, Kwon HY, et al: A randomized prospective study of single-port and four-port approaches for hysterectomy in terms of postoperative pain. Surg Endosc 2011;25:2462–2469.
23.
Fauci JM, Schneider KE, Frederick PJ, Wilding G, Consiglio J, Sutton AL, et al: Assessment of risk factors for 30-day hospital readmission after surgical cytoreduction in epithelial ovarian carcinoma. Int J Gynecol Cancer 2011;21:806–810.
24.
Hamilton B, McClellan SN, Rettenmaier MA, Goldstein BH: Laparoscopic supracervical hysterectomy for benign gynecologic conditions. JSLS 2009;13:19–21.
© 2012 S. Karger AG, Basel
2012
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.