Transfers and anesthesia-related postoperative outcomes after 3361 same-day cancer surgeries at a freestanding surgery center: An observational retrospective study Journal Article


Authors: Simon, N. B.; McCready, T. M.; Serafin, J.; Assel, M.; Jewell, E.; Mehta, M.; Vickers, A. J.; Barnett, K. M.
Article Title: Transfers and anesthesia-related postoperative outcomes after 3361 same-day cancer surgeries at a freestanding surgery center: An observational retrospective study
Abstract: Background and Objectives: Expanding outpatient surgery to the increasing number of procedures and patient populations warrants continuous evaluation of postoperative outcomes to ensure the best care and safety. We describe adverse postoperative outcomes and transfer rates related to anesthesia in a large sample of patients who underwent same-day cancer surgery at a freestanding ambulatory surgery center. Methods: Between January 2017 and June 2021, 3361 cancer surgeries, including breast and plastic, head and neck, gynecology, and urology, were performed. The surgeries were indicated for diagnosis, staging, and/or treatment. We report the incidence of transfers and adverse postoperative outcomes related to anesthesia. Results: Breast and plastic surgeries were the most common (1771, 53%), followed by urology (1052, 31%), gynecology (410, 12%), and head and neck surgeries (128, 4%). Based on patients' first procedure, comorbidity levels were highest for urology (75% American Society of Anesthesiologists physical status score 3, 1.7% score 4) and lowest for breast surgeries (31% score 3, 0.2% score 4). Most gynecology surgeries used general anesthesia (97.6%), whereas breast surgeries used the least (38%). A total of seven patients (0.2%; 95% CI: 0.08%−0.4%) were immediately transferred to an outside hospital; four due to anesthesia-related reasons. Only 7 (0.2%) patients needed additional postoperative care related to anesthesia-related adverse events, specifically cardiac events (4), difficult intubations (2), desaturation (1), and agitation, nausea, and headache (1). Conclusions: The incidence of anesthesia-related adverse postoperative outcomes is low in cancer patients undergoing outpatient surgeries at our freestanding ambulatory surgery center. This suggests that carefully selected cancer patients, including patients with metastatic cancer, can undergo anesthesia for same-day surgery, making cancer care accessible locally and reducing stress associated with travel for treatment. More research investigating complication rates related to surgery and to cancer disease trajectory are needed to establish a complete evaluation of safety for outpatient cancer surgery. © 2024 Wiley Periodicals LLC.
Keywords: cancer; adverse postoperative outcomes; ambulatory anesthesia
Journal Title: Journal of Surgical Oncology
Volume: 129
Issue: 8
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2024-06-15
Start Page: 1442
End Page: 1448
Language: English
DOI: 10.1002/jso.27643
PUBMED: 38685751
PROVIDER: scopus
PMCID: PMC11331359
DOI/URL:
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Kara Barnett -- Source: Scopus
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MSK Authors
  1. Elizabeth Jewell
    131 Jewell
  2. Andrew J Vickers
    882 Vickers
  3. Meghana Mehta
    18 Mehta
  4. Melissa Jean Assel
    110 Assel
  5. Kara Michelle Barnett
    15 Barnett
  6. Joanna Serafin
    12 Serafin