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Same-day dismissal for endometrial cancer robotic surgery: feasibility factors

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Abstract

The aim of this study was to investigate the factors in feasibility and safety of same-day dismissal (SDD) of endometrial cancer patients undergoing robotic hysterectomy and staging. A single-institution retrospective chart review of endometrial cancer patients who underwent robotic hysterectomy and staging between 2012 and 2021 was performed. Patient demographics, medical and surgical history, intra- and postoperative events were examined as possible factors related to non-SDD. These factors were analyzed using univariate (chi-square test) and multivariate logistic regression analysis. Of the 292 patients, 117 (40%) had SDD, and 175 (60%) had non-SDD. The SDD rate increased from 13.8% to 88% over the 10-year study period. The factors significantly associated with non-SDD (p < 0.05) were surgery in the first 5 years after the introduction of the SDD and ERAS protocols (2012–2016), age > 75 years, and comorbidities such as cardiovascular diseases, anemia (Hb < 11 g/dl), and anticoagulant therapy. Extensive adhesiolysis, the performance of complete pelvic and/or aortic lymphadenectomy, operating time > 180 min, and PACU discharge after 2:00 p.m. were significant factors for non-SDD. Sentinel lymph node sampling was significantly associated with SDD (OR 0.050; CI 0.273–0.934, p = 0.029). We reported no significant difference in the number, setting and timing of any unscheduled postoperative contacts, complications, and readmissions between SDD and non-SDD groups. SDD after robotic hysterectomy and staging for endometrial cancer is feasible and safe. There are patient and surgery factors for the failure of SDD. The sentinel lymph node sampling was significantly associated with achieving SDD. Trial registration: Institutional Review Board approved the study protocol (#: 1764–05).

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Medical and Surgical Gynecology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA

    Andrea Giannini, Javier F. Magrina, Paul M. Magtibay & Kristina A. Butler

  2. Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy

    Andrea Giannini

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  1. Andrea Giannini
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  2. Javier F. Magrina
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Contributions

AG contributed to conceptualization, data collection, and writing. JFM and KAB contributed to conceptualization, writing, editing, and supervision. PMM contributed to conceptualization, revision, and data collection.

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Correspondence to Kristina A. Butler.

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Conflict of interest

Andrea Giannini, Javier F. Magrina, Paul M. Magtibay, and Kristina A. Butler have no conflicts of interest or financial ties to disclose. 

Research involving human participants and/or animals

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinky (as revised in 2013). Institutional Review Board of Mayo Clinic approved the study protocol (#: 1764–05).

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Informed consent was obtained from each patient prior to any procedure specific to clinical investigations.

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Giannini, A., Magrina, J.F., Magtibay, P.M. et al. Same-day dismissal for endometrial cancer robotic surgery: feasibility factors. Updates Surg 75, 743–755 (2023). https://doi.org/10.1007/s13304-022-01424-0

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  • DOI: https://doi.org/10.1007/s13304-022-01424-0

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