title: Clinical outcomes after fast-track care in women undergoing laparoscopic hysterectomy.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of multimodal perioperative care after laparoscopic hysterectomy.
  
  
  METHODS
  A prospective observational study was performed at Clara Campal Comprehensive Cancer Center, Madrid, Spain, between April 1, 2011, and July 30, 2014, and included women who were scheduled to undergo a laparoscopic hysterectomy. Fast-track (multimodal) care included provision of full preoperative verbal and written information, intravenous dexamethasone (8 mg) during surgery, removal of the urinary catheter at the end of surgery, and early mobilization and solid food intake. The main outcome was the length of hospital stay.
  
  
  RESULTS
  Overall, 88 patients were included. The median hospital stay was 22.7 hours (range 5-72). Same-day discharge was feasible in 24 (27%) patients. A total of 51 (58%) women were discharged after overnight stay, 46 (90%) of whom elected to do so because of personal preference. Finally, 13 (15%) patients were discharged at least 36 hours after surgery. Eleven (13%) women visited the emergency unit after discharge and 3 (3%) were readmitted.
  
  
  CONCLUSIONS
  The perioperative multimodal recovery program is safe and feasible in a selected group of women after an elective laparoscopic hysterectomy.
authors.affiliation: Gynecology Department, Valencian Institute of Oncology, Valencia, Spain; Gynecology Oncology Unit, Clara Campal Comprehensive Cancer Center, Madrid, Spain. Electronic address: miniglucas@gmail.com.
authors.forename: Lucas
authors.initials: L
authors.lastname: Minig
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Linus
authors.initials: L
authors.lastname: Chuang
authors.affiliation: Gynecology Oncology Unit, Clara Campal Comprehensive Cancer Center, Madrid, Spain.
authors.forename: Maria Guadalupe
authors.initials: MG
authors.lastname: Patrono
authors.affiliation: Gynecology Oncology Unit, Clara Campal Comprehensive Cancer Center, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Fernandez-Chereguini
authors.affiliation: Department of Applied Mathematics and Statistics, CEU San Pablo University, Madrid, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Cárdenas-Rebollo
authors.affiliation: Abdomino-Pelvic Surgery Department, European Institute of Oncology, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Biffi
mesh_terms: D000328:Adult; D000368:Aged; D020878:Device Removal; D003907:Dexamethasone / Q000008:administration & dosage; D004434:Early Ambulation; D005240:Feasibility Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D057240:Patient Preference; D019990:Perioperative Care / Q000379:methods*; D011446:Prospective Studies; D013030:Spain; D062885:Urinary Catheters / Q000706:statistics & numerical data
chemical_list: D003907:Dexamethasone
keywords: Fast-track care; Hospitalization time; Laparoscopic hysterectomy; Multimodal care; Perioperative care; Postoperative complications; Safety