• Teresa Purzner, Jamie Purzner, Eric M Massicotte, and Mark Bernstein.
• Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
• Neurosurgery. 2011 Jul 1;69(1):119-26; discussion 126-7.

BackgroundOutpatient craniotomy, biopsy, and spinal decompression have been performed at our center for more than a decade. Early feasibility studies suggest that they are safe, successful, cost-effective, and well-tolerated by patients. However, a large-scale study of this magnitude has not been performed.ObjectiveTo characterize postoperative complications and the rate of successful discharge from the day surgery unit (DSU). We also discuss patient satisfaction and benefits to flow of care.MethodsFrom August 1996 to December 2009, 1003 consecutive patients were prospectively selected as outpatient candidates. Retrospective chart review was performed for all procedures and analyzed by intent to treat.ResultsOf 249 patients who underwent a craniotomy, 92.8% were successfully discharged from the DSU, 5.2% were admitted from the DSU, and 2.0% were discharged and later readmitted. Of 602 patients who underwent spinal decompression, 97.3% were successfully discharged from the DSU, 2.5% were admitted from the DSU, and 0.2% were discharged and readmitted at a later date. Of 152 patients who underwent a brain biopsy, 94.1% were successfully discharged from the DSU, 4.6% were admitted from the DSU, and 1.3% were discharged and later readmitted. No patients experienced a negative outcome as a result of early discharge.ConclusionOutpatient craniotomy, biopsy, and spinal decompression are safe, successful, and cost-effective.

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