There are common concerns regarding the safety of fast-track laparoscopic
hysterectomy. Despite postoperative management being
aimed at reducing complications and the length of hospital stay, and increasing
patient satisfaction, a main reason to delay discharge is often to
detect postoperative complications such as bleeding or intraoperative
organ damage. It has been well demonstrated that postdischarge complications
after laparoscopic hysterectomy unfortunately do occur, but
they can appear 2–3 days after discharge [7,8,13]. Schiavone et al. [10]
evaluated 128 634 women who had undergone a laparoscopic hysterectomy
and showed a 4.0%, 3.6%, and 5.1% rate of re-evaluation within
60 days for women discharged on the same day of surgery, for those
discharged after a 24-hour stay, and for those whose length of stay
was 2 days or longer, respectively (P b 0.001). The multivariable analysis
showed that patients discharged on postoperative day 1 were 11% (rate
ratio 0.89; 95% confidence interval 0.82–0.96) less likely to require reevaluation
than women discharged on the day of surgery. However,
re-evaluations of patients discharged on the same day of surgery
showed mild complications with minor symptoms [10]. Therefore, delayed
hospital discharge to detect early complications does not seem
to be justified on the basis of the results of the present study and
those of other case series [7,10–12].