Ambulatory surgery for breast cancer patients

Background: Less than two decades ago, early discharge of mastectomy patien ts was found to be possible while the drains were still in place, without n oticeable consequences for patients. Most reported studies focused on surgi cal complication rates and found no significant evidence of it. The objecti ve of the present study was to compare inpatient to same-day discharge surg ery for breast cancer, on unselected patients. Methods: All interviewed patients (n = 90) had routine level I and Il axill ary lymph node dissection under general anesthesia, combined with breast su rgery for most of them. The outpatient group comprised 55 patients and the inpatient group 35. Psychological distress was assessed, as well as pain, a nxiety, quality of life, emotional adjustment, recovery, social relations, stressful life events, and so on. Results: The sociodemographic characteristics of both surgery groups was qu ite similar, except that time from surgery to interview was about 1 year lo nger for inpatients. Outpatients and hospitalized patients report similar l evels of pain, fear, anxiety, health assessment, and quality of life. Ambul atory patients manifest a significantly better emotional adjustment and few er psychological distress symptoms. Inpatients reported that it took an ave rage of 27 days to feel that they had recovered from surgery, about 10 days longer than outpatients. Inpatient return to usual activities was also abo ut 11 days later. Conclusions: Same-day discharge patients are not at a disadvantage compared to hospitalized patients; i.e., they report faster recovery and better psy chological adjustment. Outpatient surgery may thus foster patient emotional well-being better than routine hospitalization.