COVID19 Pandemic Impact on Same-Day Discharge Rates after Minimally Invasive Surgery for Endometrial Cancer

Study Objective To determine if the COVID19 pandemic increased the rate of same-day discharge (SDD) after minimally invasive surgery (MIS) for endometrial cancer. Design Retrospective cohort study of patients undergoing MIS hysterectomy for endometrial cancer for the six months before and after the COVID19 restrictions went into place on March 17, 2020. Setting Robotic or laparoscopic procedure in the low dorsal lithotomy position. Arms were tucked and padded at their sides. Patients or Participants 166 patients underwent a MIS procedure for the indication of endometrial cancer at a large, academic institution from September 1, 2019, through October 1, 2020. 80 patients prior to the implementation of the COVID19 restrictions and 86 patients after. Interventions COVID19 pandemic with visitor restrictions and hospital policy changes placed on March 17, 2020. Measurements and Main Results SDD rate was increased following the start of the COVID19 pandemic (40% vs 58%, p= 0.02). There were no differences between the two groups in regard to operative time (p= 0.07), estimated blood loss (EBL) (p= 0.21), uterine weight (p= 0.12), age (p= 0.06), BMI (p=0.42), or surgery start time (p= 0.15). In a multivariable logistic regression model, subjects in the post COVID19 group had a 3.08 (95% CI: 1.40, 6.74, p= 0.01) higher odds of SDD than those in the pre COVID19 group. There was no difference in 30-day readmission rates (7.5% vs 5.8%, p=0.66). Conclusion With no additional interventions from a surgical standpoint, the start of the COVID19 pandemic improved SDD rates. The reason for this is speculative but may be related to patient and physician desire to keep patients out of the hospital and may provide further evidence that subjective reasons lead to an increase in hospital length of stay.