Feasibility and associated factors of same-day discharge after hysteroscopic-laparoscopic surgery for infertility under ERAS: a prospective observational study.

Despite the increasing adoption of Enhanced Recovery After Surgery (ERAS) protocols, same-day discharge after hysteroscopic-laparoscopic surgery for infertility remains underexplored, particularly in terms of its clinical implementation and influencing factors. This prospective observational study included 104 infertile women who underwent combined hysteroscopic-laparoscopic surgery. All patients received standardized ERAS care and were categorized into same-day and non-same-day discharge groups by actual discharge time. Same-day discharge was achieved in 51 of the 104 patients (49.0%). All non-same-day discharged patients met the objective discharge criteria, and the between-group difference did not reflect poorer postoperative recovery. Postoperative complication rates were low and comparable between groups (3.92% vs. 5.66%), with no unplanned reoperations or 30-day readmissions. Factors independently associated with same-day discharge were a residential distance > 30 km (OR 0.108; 95% CI 0.036-0.325; P < 0.001), a surgical end before 15:00 (OR 7.862; 95% CI 2.609-23.694; P < 0.001), and prior abdominal surgery (OR 6.501; 95% CI 1.796-23.535; P = 0.004). Same-day discharge is feasible under ERAS management in appropriately selected patients, and that the actual discharge timing is influenced by logistical and non-clinical factors.