title: Outpatient laparoscopic nerve-sparing radical hysterectomy: A feasibility study and analysis of perioperative outcomes.
abstract: OBJECTIVE
  The goal of our study was to report on the feasibility of outpatient laparoscopic radical hysterectomy in patients with early-stage cervical cancer.
  
  
  METHODS
  We included all patients who underwent a laparoscopic radical hysterectomy at the Instituto de Cancerología - Las Americas in Medellin, Colombia, between January 2013 and July 2015. The control group was a similar cohort of patients who were admitted after their surgery.
  
  
  RESULTS
  Seventy-six patients were included [outpatient (31) and admitted (45)]. There were no statistically significant differences between groups regarding age, clinical stage, histology, nodal count, need of adjuvant treatment, visual pain scores at discharge or follow up time. All patients underwent a transversus abdominis plane block. The median operative time was 150min (range, 105-240) in the outpatient group vs. 170min (range, 97-300) in the admitted group (p=0.023). The median estimated blood loss was 50ml (range, 20-150) in the outpatient group vs. 120ml (range, 20-1000) in the admitted group (p=0.001). All patients were able to void spontaneously and tolerate a diet before discharge. In patients who were admitted, the median hospital stay was 1day, (range; 1-6), and 39 (87%) were discharged at postoperative day 1. There were 6 postoperative complications, 3 in each group. There were no recurrences in the follow-up period in the outpatient group, and there were 3 (6.6%) recurrences in the admitted group.
  
  
  CONCLUSIONS
  Outpatient laparoscopic radical hysterectomy is feasible and can be performed safely in a developing country in well-selected patients.
authors: Department of Gynecologic Oncology, Instituto de Cancerología - Las Américas, Medellín, Colombia.
authors: Gabriel J
authors: GJ
authors: Rendón
authors: Department of Gynecologic Oncology, Instituto de Cancerología - Las Américas, Medellín, Colombia.
authors: Lina
authors: L
authors: Echeverri
authors: Department of Anesthesiology, Clínica Las Américas, Medellín, Colombia.
authors: Francisco
authors: F
authors: Echeverri
authors: Head Gynecologic Oncology Unit, Group of Hospitals, Madrid, Spain.
authors: Carlos Millán
authors: CM
authors: Sanz-Lomana
authors: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
authors: Pedro T
authors: PT
authors: Ramirez
authors: Professor Universidad Pontificia Bolivariana (UPB), Universidad CES, Medellín and Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia. Electronic address: ajerapener@gmail.com.
authors: Rene
authors: R
authors: Pareja
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D059035:Perioperative Period; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000601:surgery*
keywords: Laparoscopy; Outpatient; Radical hysterectomy