Early discharge OK in laparoscopic hysterectomy: avoiding an overnight stay.(gynecology)

LAS VEGAS--Women who chose to go home the same day after laparoscopic hysterectomy fared as well as those who stayed longer in the hospital in a study of 359 patients.

After undergoing total or supracervical laparoscopic hysterectomy in Kaiser Permanente San Diego hospitals during an 18-month period, 81 patients said they felt good and wanted to go home the same day, and 278 stayed longer in the hospital. In each group, 4% of patients developed major complications. The rate of read-missions did not differ significantly between groups: 5% in the same-day group and 2% in the longer-stay group, Dr. Alexandra E. Kidd said at the annual meeting of the American Association of Gynecologic Laparoscopists.

Rates of minor complications were comparable between groups (10% vs. 18%), added Dr. Kidd of the University of California, San Diego.

Women in the same-day group had a significantly lower mean body mass index (27 vs. 29), shorter surgical times (112 minutes vs. 140 minutes), lower estimated blood loss (60 cc vs. 109 cc), and, of course, a shorter length of stay (10 hours vs. 37 hours).

There were no differences between groups in age, parity, uterine weight, other procedures performed, or postoperative diagnoses.

More than 90% of patients in the same-day group went home within 12 hours of registering at the hospital; the remaining patients in this group were discharged in 13-18 hours.

The three major complications in the same-day group involved one ureterovaginal fistula diagnosed several weeks after surgery and two patients who required a second surgery for delayed vaginal bleeding several weeks after hysterectomy. In the longer-stay group, major complications involved five bladder injuries recognized at surgery and repaired laparoscopically, three ...