title: Outpatient brain tumor surgery and spinal decompression: a prospective study of 1003 patients.
abstract: BACKGROUND
  Outpatient craniotomy, biopsy, and spinal decompression have been performed at our center for more than a decade. Early feasibility studies suggest that they are safe, successful, cost-effective, and well-tolerated by patients. However, a large-scale study of this magnitude has not been performed.
  
  
  OBJECTIVE
  To characterize postoperative complications and the rate of successful discharge from the day surgery unit (DSU). We also discuss patient satisfaction and benefits to flow of care.
  
  
  METHODS
  From August 1996 to December 2009, 1003 consecutive patients were prospectively selected as outpatient candidates. Retrospective chart review was performed for all procedures and analyzed by intent to treat.
  
  
  RESULTS
  Of 249 patients who underwent a craniotomy, 92.8% were successfully discharged from the DSU, 5.2% were admitted from the DSU, and 2.0% were discharged and later readmitted. Of 602 patients who underwent spinal decompression, 97.3% were successfully discharged from the DSU, 2.5% were admitted from the DSU, and 0.2% were discharged and readmitted at a later date. Of 152 patients who underwent a brain biopsy, 94.1% were successfully discharged from the DSU, 4.6% were admitted from the DSU, and 1.3% were discharged and later readmitted. No patients experienced a negative outcome as a result of early discharge.
  
  
  CONCLUSIONS
  Outpatient craniotomy, biopsy, and spinal decompression are safe, successful, and cost-effective.
authors.affiliation: Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Teresa
authors.initials: T
authors.lastname: Purzner
authors.forename: Jamie
authors.initials: J
authors.lastname: Purzner
authors.forename: Eric M
authors.initials: EM
authors.lastname: Massicotte
authors.forename: Mark
authors.initials: M
authors.lastname: Bernstein
mesh_terms: D001706:Biopsy / Q000379:methods; D001932:Brain Neoplasms / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D010045:Outpatients; D011183:Postoperative Complications; D012189:Retrospective Studies; D013116:Spinal Cord / Q000601:surgery*