Systematic review of day surgery for breast cancer

Background: Over the last decade, breast cancer surgery has become less invasive and potentially suitable for day surgery. The aim of this systematic review was to establish the benefits and disadvantages of day surgery for breast cancer. Methods: A systematic search of the Cochrane Library, Medline, British Nursing Index, CINAHL, EMBASE and PsycINFO was carried out. All relevant papers were assessed for their methodological quality using a checklist designed to assess both randomised and non-randomised studies with specific questions added to address outcome measures. Results: No randomised controlled trials were found in literature. Eleven observational studies were included. The rate of discharge after day surgery was universally high with very low acute readmission rates. Intractable vomiting, patient anxiety and pain control were the main reasons for failing discharge. Patient satisfaction with day surgery was high and psychological recovery was quicker, however, majority of the studies did not use validated questionnaires. The hospital costs were lower for day surgery. Conclusions: Day surgery for breast cancer is safe, with equivalent complication rates, but there is lack of evidence from randomised controlled trials. Patient satisfaction and psychological well-being is high. Further trials with validated questionnaires are required to confirm this. (C) 2009 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.