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01-05-2020 | Laparoscopy

Prediction of early discharge after gynaecological oncology surgery within ERAS

Authors: Eric Lambaudie, Jérome Mathis, Christophe Zemmour, Camille Jauffret-Fara, Elie Toni Mikhael, Camille Pouliquen, Renaud Sabatier, Clément Brun, Marion Faucher, Djamel Mokart, Gilles Houvenaeghel

Published in: Surgical Endoscopy | Issue 5/2020

Abstract

Objectives

Enhanced recovery after surgery programs (ERAS) have been proven to decrease the length of hospital stay without increasing readmission rates or complications. However, the patient and operative characteristics that improve the chance of a successful early hospital discharge are not well established. The aim of this study was to design a nomogram which could be used before surgery, using the characteristics of patients, to establish who could benefit from early discharge (POD ≤ 2 days).

Methods

This observational study has been prospectively conducted. All the included patients were referred for surgical treatment of gynecologic cancer. We defined two sub-groups of patients on surgical procedure characteristics: isolated procedures (hysterectomy or lymphadenectomy) and combined procedures (at least the association of two procedures).

Results

230 patients were enrolled during the study protocol. 83.9% of patients were treated with a minimally invasive surgery (MIS). 159 patients (69.1%) were discharged on or before POD 2. On multivariate analysis, the surgical approach (open surgery vs. laparoscopy, OR 0.02 (95% CI [0–0.07]), p < 0.001) and the type of surgery (combined procedure versus isolated procedure, OR 0.41 (95% CI [0.18–0.91]), p = 0.028) were found to be significant predictors of increased hospital stay. A nomogram has been built for the purpose of predicting eligible patients for early post-operative discharge based on the multivariate analysis results (AUC = 0.86, 95% CI [0.81–0.92]).

Conclusion

The use of MIS for isolated procedures in oncologic indications constitutes an independent factor of early discharge in a setting of ERAS. These promising preliminary results still require to be validated on a prospective cohort.

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Title: Prediction of early discharge after gynaecological oncology surgery within ERAS
Authors: Eric Lambaudie
Jérome Mathis
Christophe Zemmour
Camille Jauffret-Fara
Elie Toni Mikhael
Camille Pouliquen
Renaud Sabatier
Clément Brun
Marion Faucher
Djamel Mokart
Gilles Houvenaeghel
Publication date: 01-05-2020
Publisher: Springer US
Keywords: Laparoscopy
Gynecologic Cancer
Lymphadenectomy
Hysterectomy
Minimally Invasive Surgery
Published in: Surgical Endoscopy / Issue 5/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-06974-w

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Prediction of early discharge after gynaecological oncology surgery within ERAS

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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