Safety and efficacy of same-day discharge versus overnight stay following pelvic floor reconstructive surgery: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to compare the efficacy and safety of same-day discharge (SDD) and overnight stay (OS) after pelvic floor reconstruction surgery (PFRS). We systematically searched PubMed, Web of Science, Embase, Cochrane Library, Wanfang database, CNKI database, VIP database, and CBM databases from 2015 to December 31, 2024. Primary outcome measures included 30-day hospital readmission, postoperative complications, unplanned hospital visits, reoperation, and emergency department (ED) visits. Two reviewers independently performed study selection, data extraction, and quality assessment. A meta-analysis was conducted using RevMan 5.4, and quality assessment was performed using the Newcastle-Ottawa Scale (NOS). Fourteen observational comparative studies involving 16,064 PFRS patients were included. Meta-analysis showed that compared with the OS group, the SDD group had lower incidences of postoperative complications (risk ratio [RR] = 0.55, 95% CI 0.43, 0.70, P < 0.0001), reoperation (RR = 0.62, 95% CI 0.39, 0.99, P = 0.05), and readmission (RR = 0.72, 95% CI 0.53, 0.99, P = 0.04). No significant differences were observed in 30-day unplanned hospital contact (Risk Difference = -0.04, 95% CI -0.11, 0.03, P = 0.30) or ED visits (RR = 0.87, 95% CI 0.63, 1.21, P = 0.41). SDD following PFRS appears to be associated with comparable or lower risks of adverse outcomes in appropriately selected patients. However, causal inference is limited by the observational nature of included studies. Further prospective randomized controlled trials are needed to validate its safety and develop standardized SDD guidelines.