旨在评估用于取出完整标本的剖腹探查术 (EL) 是否会对因确诊或疑似妇科恶性肿瘤而接受微创手术 (MIS) 的患者当天出院 (SDD) 的可行性或安全性产生不利影响。 回顾性研究 背景：单一机构研究 患者：在单一机构接受妇科恶性肿瘤微创手术的患者，接受剖腹探查术 (N=67) 和年龄匹配的对照组 (N=134) 干预措施：比较患者之间的当天出院率、并发症、再入院率和门诊随访情况需要进行剖腹手术的患者与微创妇科手术后不需要进行剖腹手术的患者。总共确定了 1224 名患者。 67 名患者接受了 EL 提取标本。从其余患者中，选择了 134 名患者作为年龄匹配的对照。 SDD 率为 83%（EL）与 87%（无 EL）（p=.39）。中位疼痛评分（1.8 vs. 1.9 p=.86）、住院时间（LOS）（均为 0 天）（p=.41）、30 天再入院率（6% vs. 3%）没有差异) (p=.45)、急诊就诊 (13% vs. 10%) (p=.76) 或任何患者接触 (34% vs. 39%) (p=.53)。 EL 组的标本重量较高（524g vs 142g，p<.001），估计失血量 (EBL)（104ml vs. 46ml，p<.001），并且 EL 组的手术时间增加了 22 分钟（ 121 分钟与 99 分钟，p<.001）。接受 EL 的患者在 PACU 20.5 与 12.2 OME 中确实需要更多麻醉药物 p=.033，但这并不意味着出院时处方麻醉药物数量的增加。根据逻辑回归，较高的标本重量往往会增加入院的可能性（OR 1.04 CI 1.01-1.08），但是，手术时间、PACU 时间、种族、BMI、手术类型或 EL 的需要并不能预测 SDD 或入院的需要.微创手术需要进行剖腹手术的患者仍可达到SDD。当日出院是安全可行的，不会增加再入院、疼痛评分或术后意外接触患者的风险。版权所有 © 2024。由 Elsevier Inc. 出版。

To evaluate if extraction laparotomy (EL) for intact specimen removal adversely impacted the feasibility or safety of same-day discharge (SDD) in patients undergoing minimally invasive surgery (MIS) for confirmed or suspected gynecologic malignancies.Retrospective study SETTING: Single institution study PATIENTS: Patients undergoing minimally invasive surgery for gynecologic malignancy at a single institution, who underwent extraction laparotomy (N=67) and age matched controls (N=134) INTERVENTIONS: Comparing same day discharge rates, complications, readmission and outpatient follow up after between patients requiring extraction laparotomy to those that did not after minimally invasive gynecologic surgery.A total of 1224 patients were identified. Sixty-seven patients underwent EL for specimen extraction. From the remainder, 134 patients were selected as age matched controls. SDD rate was 83% (EL) vs. 87% (no EL) (p=.39). There was no difference in median pain scores (1.8 vs. 1.9 p=.86), length of stay (LOS) (0 days for both) (p=.41), 30-day readmission rate (6% vs. 3%) (p=.45), ED visit (13% vs. 10%) (p=.76) or any patient contact (34% vs. 39%) (p=.53), between the groups. Specimen weight was higher for EL (524g vs 142g, p<.001), as was estimated blood loss (EBL) (104ml vs. 46ml, p<.001), and surgery time was increased by 22 minutes in the EL group (121 min vs. 99 min, p<.001). Patients who underwent EL did require more narcotics in PACU 20.5 vs 12.2 OME p=.033, however this did not translate to increased number of narcotics prescribed at discharge. On logistic regression a higher specimen weight trended to increase the likelihood of admission (OR 1.04 CI 1.01-1.08), however, surgery time, time in PACU, race, BMI, surgery type or need for EL did not predict SDD or need for admission.Minimally invasive surgery patients who require extraction laparotomy can still achieve SDD. Same-day discharge is safe and feasible without increased risk of readmission, pain score, or unscheduled patient contact post-operatively.Copyright © 2024. Published by Elsevier Inc.