STUDY OBJECTIVE: Whether, after laparoscopic hysterectomy (LH), selected patients may be safely and comfortably discharged on postoperative day 1 (day after surgery) using specific anesthesia and analgesia protocols that included Post Anesthetic Discharge Scoring System. DESIGN: A prospective feasibility pilot study (Canadian Task Force classification II-3). SETTING: A French tertiary care hospital. PATIENTS: A total of 35 patients who underwent total LH were selected using preestablished criteria based on age, surgical history, place of residence, and capacity to follow instructions. INTERVENTIONS: All patients had a telephone call the second and seventh day after surgery. MEASUREMENTS AND MAIN RESULTS: Of 35 patients, 34 (97.1%) left the hospital the day after surgery. One patient was not discharged on surgeon's instructions, because of technical difficulties during the procedure. Two patients (6.7%) required readmission because of complications. The first patient required hospitalization for vesicovaginal fistula at day 10 and had to undergo laparoscopic treatment of the fistula. The second consulted for hyperthermia at day 4 with suggestion of cuff cellulitis, and was discharged after 2 days of antibiotic treatment. Of 35 women, 34 (97.1%) were satisfied with the procedure and all would recommend it to other patients. CONCLUSION: Using our protocol for analgesia, anesthesia, and early discharge (24 hours after surgery) may be safely proposed after total LH in selected patients. Satisfaction rate of patients on postoperative days 7 and 30 was very high.
STUDY OBJECTIVE: Whether, after laparoscopic hysterectomy (LH), selected patients may be safely and comfortably discharged on postoperative day 1 (day after surgery) using specific anesthesia and analgesia protocols that included Post Anesthetic Discharge Scoring System. DESIGN: A prospective feasibility pilot study (Canadian Task Force classification II-3). SETTING: A French tertiary care hospital. PATIENTS: A total of 35 patients who underwent total LH were selected using preestablished criteria based on age, surgical history, place of residence, and capacity to follow instructions. INTERVENTIONS: All patients had a telephone call the second and seventh day after surgery. MEASUREMENTS AND MAIN RESULTS: Of 35 patients, 34 (97.1%) left the hospital the day after surgery. One patient was not discharged on surgeon's instructions, because of technical difficulties during the procedure. Two patients (6.7%) required readmission because of complications. The first patient required hospitalization for vesicovaginal fistula at day 10 and had to undergo laparoscopic treatment of the fistula. The second consulted for hyperthermia at day 4 with suggestion of cuff cellulitis, and was discharged after 2 days of antibiotic treatment. Of 35 women, 34 (97.1%) were satisfied with the procedure and all would recommend it to other patients. CONCLUSION: Using our protocol for analgesia, anesthesia, and early discharge (24 hours after surgery) may be safely proposed after total LH in selected patients. Satisfaction rate of patients on postoperative days 7 and 30 was very high.
Authors: Elisa R Trowbridge; Caitlin N Dreisbach; Bethany M Sarosiek; Catherine Page Dunbar; Sarah Larkin Evans; Lee Anne Hahn; Kathie L Hullfish Journal: Int Urogynecol J Date: 2017-09-04 Impact factor: 2.894