Same-Day Brain Tumor Procedures Offer Benefits to Carefully Selected Patients, According to New Sylvester Study

Same-day discharges after certain brain tumor procedures are safe and offer benefits to carefully selected patients, according to a new study by the neurosurgical team at Sylvester Comprehensive Cancer Center of the University of Miami Miller School of Medicine.

“We are the first program in the nation to publish a prospective series of same-day discharges following minimally invasive brain tumor procedures,” said Ricardo J. Komotar, M.D., professor of neurological surgery, director of Sylvester’s Brain Tumor Initiative, director of Surgical Neuro-Oncology and director of the Neuro-Oncology Fellowship Program. “We apply our team’s deep experience and specialized training to offer safe and effective outpatient procedures whenever possible.”

Outpatient brain surgery has many advantages for the psychological and physical wellbeing of patients, added Michael E. Ivan, M.D., M.B.S., associate professor of neurological surgery, and co-director and director of research of the Sylvester Brain Tumor Initiative. “We have been moving steadily in this direction for the past seven years,” he said. “Our latest study shows we can complete brain tumor procedures safely in a way that allows patients to return to a normal quality of life as quickly and safely as possible, while also reducing the overall costs to the health care system.”

Drs. Komotar and Ivan were senior authors of the study, “Same Day Discharge after Brain Tumor Resection: A Prospective Pilot Study,” published in February in the Journal of Neuro-Oncology. Miller School co-authors included Frederic A. Vallejo, Miller School student; Daniel G. Eichberg, M.D., neurosurgery resident; Alexis A. Morell, M.D., clinical research coordinator; Long Di; Katherine Berry, M.D., neurosurgery resident; Evan Luther, M.D., neurosurgery resident; Victor M. Lu, M.D., Ph.D., neurosurgeon; and Nitesh V. Patel, M.D., surgical neuro-oncology fellow.  

Neurosurgeon Ashish Shah, M.D., who is completing a clinical fellowship at the National Institutes of Health (NIH), also contributed to the study. “Same-day discharges can be particularly important when hospital beds are scarce, as was the case during the height of the COVID pandemic,” said Dr. Shah, who will be joining the UM neurosurgery team in July. “Minimally invasive procedures can frequently be done on an outpatient basis, allowing patients to recover at home.”

For the pilot study, Dr. Shah said the team at UHealth—the University of Miami Health System, chose patients in good condition with superficial, easy-to-access tumors. “We obtained follow-up brain imaging and observed from the intensive care unit (ICU) for about six hours. If no problems were observed, we got our patients out of bed with physical therapy, and discharged them later that day to go home with a family member.”

Dr. Komotar said other academic medical centers are following the progress of the UHealth neurosurgery program, as in-patient stays become shorter. “Years ago, patients with brain tumors would stay in the hospital for several days,” he said. “Over the last decade, we have been able to steadily increase the percentage of outpatient procedures, thanks to our well-coordinated, comprehensive care team.”

Same-day discharges are the next step in that evolution, added Dr. Komotar. “We talk with our patients about their options and ask if they are comfortable going home the same day if there are no issues,” he said. “They are usually surprised to learn about the possibility, and say yes.”

Looking ahead, Dr. Komotar said the team plans to offer same-day discharges to patients with a wider array of brain tumors. “We will always maintain our focus on patient safety, as well as quality of life,” he said. “Having the potential option of going home the same day after surgery is a major benefit for our patients.”

Tags: brain tumors, Dr. Ashish Shah, Dr. Michael Ivan, Dr. Ricardo Komotar, Sylvester Comprehensive Cancer Center, UHealth