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Discharge 24 hrs after hysterectomy can be safe

NEW YORK (Reuters Health) - Patient discharge 24 hours after vaginal hysterectomy can be safe and acceptable, according to a report in the BJOG: An International Journal of Obstetrics and Gynecology.

Dr. Anthony Griffiths from the University Hospital of Wales, Cardiff, and associates assessed the safety and acceptability of this procedure in 71 women from one practice. The only requirements were having a home environment suitable for recovery after early discharge and a body mass index of less than 40, indicating the woman could not be morbidly obese.

Sixty-five of the women (91.5 percent) were discharged home within 24 hours of the operation, the authors report. Among the remaining six, three were electively admitted for postoperative pain management.

Only one woman required a laparotomy procedure due to abdominal bleeding 6 hours after the operation, the report indicates. Another woman was admitted for less than 24 hours for a suspected blood clot in the lung, and the third woman, a Jehovah’s Witness, was kept for 36 hours because of blood loss during surgery.

Four of the 65 women discharged within 24 hours had to be readmitted 7 to 10 days after surgery for symptoms of mild infection. These cases were then treated on an outpatient basis with oral antibiotics and drugs to control the pain, the researchers note.

“Vaginal hysterectomy performed as a 24-hour day case procedure appears to be safe and acceptable with significant benefits for the women and health provider alike,” Griffiths and colleagues conclude. This surgery can be successful in most women who would traditionally undergo hysterectomy through the abdominal route and have a longer hospital stay.

Because this approach is relatively new in the UK, the investigators add, it is important to closely monitor patients to be sure the procedure remains safe.

SOURCE: BJOG: An International Journal of Obstetrics and Gynecology, April, 2007.