Safety and Health Economic Benefits of Primary Palatoplasty With the Day Surgery Pathway: A Retrospective Study.

OBJECTIVES

To present a day surgery protocol for primary palatoplasty and assess its safety and efficacy through surgical outcomes and health economic indicators.

METHODS

A single-center retrospective study was conducted at Shanghai Ninth People's Hospital between January 2018 and August 2025, screening patients undergoing primary palatoplasty. A 1:1 propensity score matching was performed for sex, age, cleft palate classification, and American Society of Anesthesiologists grade from the day surgery group and the inpatient group. Postoperative outcomes, medication utilization patterns, and health economic indicators were compared.

RESULTS

Each cohort included 374 patients. Baseline characteristics were well-balanced after matching (all P>0.05). The day surgery group exhibited significantly shorter operative time (50 versus 50 min, P=0.025), anesthesia time (70 versus 75 min, P<0.001), and Post-Anesthesia Care Unit discharge time (80 versus 90 min, P<0.001). No significant between-group differences were observed in intraoperative blood loss, overall complications, 30-day readmission or reoperation rates (P>0.05), and no severe complication was reported. One patient in the day surgery group developed postoperative upper airway edema requiring an extended hospital stay for 1 additional day. The day surgery group had a shorter length of stay (24 versus 119.05 h, P<0.001) and reduced total hospitalization costs (median 70.7% of the inpatient group's costs, P<0.001).

CONCLUSIONS

For low-risk cleft palate patients, surgery performed under a mature protocol at a day surgery ward is safe, shortens hospital stays, reduces costs, and aligns with enhanced recovery after surgery principles.