Enhanced Recovery and Same-Day Discharge After Minimally Invasive Sacrocolpopexy. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Evans, Sarah; McCarter, Maggie; Abimbola, Obafunbi; Myers, Erinn M.
• Is Part Of: Female pelvic medicine & reconstructive surgery. Volume 27:Issue 12(2021)
• Publication Date: 2021-12
• Subjects: same-day discharge -- enhanced recovery -- minimally invasive sacrocolpopexy; Pelvis -- Diseases -- Periodicals; Pelvis -- Surgery -- Periodicals; Genital Diseases, Female -- surgery -- Periodicals; Urologic Diseases -- surgery -- Periodicals; Colonic Diseases -- surgery -- Periodicals; Rectal Diseases -- surgery -- Periodicals; Surgical Procedures, Operative -- methods -- Periodicals; 616.6
• DOI: 10.1097/SPV.0000000000001043
• Languages: English
• ISSNs: 2151-8378

Abstract

Abstract : Objective: The objective of this study was to evaluate whether an enhanced recovery after surgery (ERAS) protocol was associated with a higher rate of same-day discharge after robot-assisted or laparoscopic sacrocolpopexy and to describe the safety and feasibility of same-day discharge after these procedures. Methods: A historical control, retrospective cohort study of women undergoing minimally invasive sacrocolpopexy comparing rates of same-day discharge before and after implementation of an ERAS protocol was conducted. Secondary outcomes were obtained by comparing women discharged the same day with those discharged postoperative day ≥1, including postoperative complications and unplanned postoperative patient encounters within 30 days of surgery. Logistic regression was performed to control for potential confounders. Results: Of the 166 women identified (83 before ERAS implementation; 83 after ERAS implementation), 43 underwent same-day discharge versus 123 admitted overnight. The rate of same-day discharge increased 28 percentage points after ERAS implementation (12% vs 40%, P < 0.01). Compared with women admitted overnight, same-day discharge women had shorter procedures (154 vs 173 minutes, P = 0.01), spent longer time in the postanesthesia care unit (130 vs 106 minutes, P = 0.01), and were more likely to be discharged with a Foley catheter (58% vs 28%, P < 0.01). After multivariable logistic regression analysis, ERAS was associated with increased odds of same-day discharge (odds ratio, 4.91; 95% confidence interval, 2.17–11.09). There were no differences in unplanned postoperative patient contacts or postoperative complications within 30 days between same-day discharge and overnight admission groups. Conclusions: Implementation of an ERAS protocol for minimally invasive sacrocolpopexy was associated with a 3-fold increase in same-day discharge.