Our Summary

This research looks at how often patients need to unexpectedly stay overnight at the hospital after having a less invasive type of hysterectomy (a surgery to remove the uterus), when they were expected to be able to leave the same day. The study also looked at what factors might have led to these unexpected overnight stays.

The study looked at 372 patients who had this kind of surgery between March 2019 and July 2021 at one hospital. Of these, about 70% were expected to be able to leave the hospital the same day, while about 30% were expected to need to stay overnight.

Of those expected to be able to leave the same day, about 88% were able to do so, while about 12% ended up needing to stay overnight. The main reasons these patients needed to stay overnight were issues related to anesthesia, issues with the hospital system, unexpected issues during the surgery, pain after surgery, and personal factors.

Of those who were expected to need to stay overnight, about 73% needed to for reasons related to other health issues or the complexity of their surgery. However, about 27% could potentially have left the same day if certain things had been better managed before the surgery. These things included managing other health issues, addressing hospital system issues, addressing personal factors, and changing the preference of the provider.

The study concluded that most patients having this type of surgery can safely leave the hospital the same day. It also suggested that managing other health issues better before surgery could help reduce the number of patients who need to unexpectedly stay overnight.

FAQs

  1. What is the rate of avoidable admissions following anticipated same-day discharge for patients undergoing minimally invasive hysterectomy?
  2. What are some of the reasons for day-of-surgery admission despite anticipated same-day discharge?
  3. What factors can be optimized pre-operatively to reduce potentially avoidable admissions?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hysterectomy is to carefully follow all pre-operative instructions provided by your healthcare team. This may include managing any comorbidities, addressing social factors that could impact recovery, and ensuring that all necessary arrangements are in place for a smooth post-operative experience. By following these instructions, you can increase the likelihood of a successful same-day discharge and minimize the risk of avoidable admissions.

Suitable For

Patients who are typically recommended hysterectomy include those with gynecologic conditions such as uterine fibroids, endometriosis, abnormal uterine bleeding, pelvic organ prolapse, and gynecologic cancers such as uterine, cervical, or ovarian cancer. Additionally, patients with chronic pelvic pain or other conditions that have not responded to conservative treatments may also be recommended for hysterectomy. The decision to undergo hysterectomy is usually made after careful consideration of the patient’s individual medical history, symptoms, and goals for treatment.

Timeline

  1. Pre-operative assessment: Patients undergoing minimally invasive hysterectomy are assessed for same-day discharge versus planned admission based on factors such as comorbidities, surgical complexity, and social factors.

  2. Day of surgery: Patients who are anticipated same-day discharges undergo the minimally invasive hysterectomy procedure.

  3. Post-operative period: Following the procedure, patients who are successfully discharged the same day may experience a smooth recovery at home. However, some patients may require admission due to reasons such as anesthesia-related issues, system issues, intra-operative factors, post-operative pain, or social factors.

  4. Planned admissions: Patients who are deemed not candidates for same-day discharge are pre-operatively planned for admission. These admissions may be necessary due to comorbidities or surgical complexity, or potentially avoidable if patients could have been optimized for same-day discharge.

  5. Optimization opportunities: Potentially avoidable admissions can be prevented by better optimizing patients pre-operatively, addressing factors such as comorbidities, system issues, social factors, and provider preference.

Overall, the study highlights the importance of careful pre-operative assessment and optimization to reduce avoidable admissions following minimally invasive hysterectomy.

What to Ask Your Doctor

  1. What are the different types of hysterectomy procedures available, and which one is the most suitable for my condition?
  2. What are the potential risks and complications associated with hysterectomy surgery?
  3. What is the expected recovery time after hysterectomy surgery?
  4. Will I experience any changes in my hormonal balance after hysterectomy, and how can they be managed?
  5. Are there any alternative treatments to hysterectomy that I should consider?
  6. How will hysterectomy affect my future fertility and sexual function?
  7. Will I need to take hormone replacement therapy after hysterectomy?
  8. How should I prepare for the surgery, both physically and mentally?
  9. What can I expect in terms of pain management and post-operative care?
  10. What follow-up appointments will be necessary after the surgery?

Reference

Authors: Manorot A, Uppal S, de Bear O, Stroup C, Dalton L, Rolston A, McCool K, Reynolds RK, McLean K, Siedel J, Straubhar AM. Journal: Int J Gynecol Cancer. 2024 Sep 2;34(9):1431-1436. doi: 10.1136/ijgc-2024-005391. PMID: 39122446