Safety and Feasibility of Same-Day Discharge in Obese XXXX Undergoing Laparoscopic Hysterectomy for @entity1478 and Malignancy [335].

@entity1204 @entity1 @entity28 @entity260 @entity281 @entity1478
INTRODUCTION: Hysterectomy for @entity1204 is increasingly performed by laparoscopic surgical technique. Same-day discharge is safe, cost-saving, and acceptable to @entity1 undergoing laparoscopic hysterectomy, but concerns about increased perioperative risks in @entity28 @entity1 limit the utilization of same-day discharge in this population. We evaluated the risk of perioperative complications in @entity28 @entity1 undergoing laparoscopic hysterectomy for @entity1204 or @entity1478 in our institution during a period of rapid increase in the utilization of same-day discharge. METHODS: Single-institution retrospective cohort including all @entity28 @entity1 (body mass index [calculated as weight (kg)/[height (m)]] 30) undergoing laparoscopic hysterectomy for @entity1204 or @entity1478 between 2011 and 2013. RESULTS: A total of 388 @entity1 were included. Those with class III @entity28 were younger than those with class I or II (58.4 compared with 63.0 years, P<.001) and less likely to have invasive @entity1204 (80.9% compared with 88.7%, P=.04). Those with class III @entity28 were significantly more likely to undergo robot-assisted laparoscopy than those with class I or II @entity28 (57.5% compared with 18.6%, P<.001). The rate of same-day discharge increased significantly over the 3-year study period: for those with class I and II @entity28 from 18.6% to 65.5% and for those with class III @entity28 from 12.7% to 61.4% (P<.001). During this period there were no significant differences in frequency of @entity260 within 30 days of surgery, including readmission, unscheduled surgery, or @entity281 (P=.1 for all). CONCLUSION: Same-day discharge is safe and feasible for the majority of @entity28 @entity1 undergoing laparoscopic surgery for @entity1204 and @entity1478 .
