# Outpatient Surgery in Neuro-Oncology—Advancing Patient Access and Care

## TL;DR

Outpatient neurosurgery for brain tumors is becoming safer and more common thanks to new techniques and monitoring, allowing patients to go home the same day without more complications.

## Contribution

The paper provides evidence that outpatient neurosurgery can be safely implemented with structured protocols, leading to cost savings and improved patient comfort.

## Key findings

- Same-day discharge rates for outpatient neurosurgery range from 85 to 95% with low complication rates (3–6%).
- Structured pathways and enhanced recovery protocols reduce hospital stays and costs without increasing adverse events.
- Telemedicine and emerging technologies like laser interstitial thermal therapy may expand outpatient neuro-oncology options.

## Abstract

Advances in brain tumor care such as better imaging, safer anesthesia, and minimally invasive surgical tools now make it possible for some neurosurgery patients to go home the same day as their procedure. This review explains how carefully selected patients can safely recover at home after operations like craniotomy or brain biopsy, supported by close monitoring, clear instructions, and early follow-up. Research from many countries shows that outpatient neurosurgery can reduce costs, shorten hospital stays, and improve comfort without increasing complications. Some challenges remain to ensure surgeon confidence in this pathway, and appropriate patient education, the growing use of enhanced recovery pathways, and telemedicine are helping make outpatient neurosurgical oncology a safe, efficient, and patient-centered approach to care.

Outpatient neurosurgical oncology has expanded with advances in anesthesia, imaging, and minimally invasive techniques, enabling safe same-day discharge for selected patients undergoing procedures such as stereotactic biopsy and craniotomy. In this review, we find that across multiple international series, same-day discharge rates in several studies ranging from 85 to 95%, with low complication (3–6%) and readmission rates when structured pathways, including standardized selection criteria, enhanced recovery protocols, and routine 4-h postoperative CT imaging, are used. Studies on economic analyses demonstrate substantial cost savings driven by reduced inpatient bed utilization, with no increase in adverse events. Key challenges identified include medicolegal concerns amongst physicians, patient education, and limitations in organization adoption. Telemedicine and remote monitoring are increasingly incorporated to streamline preoperative evaluation and postoperative follow-up, improving access and continuity of care. Emerging technologies such as laser interstitial thermal therapy and focused ultrasound may further expand the outpatient neuro-oncology repertoire. Overall, current evidence supports outpatient neurosurgical oncology as a safe, efficient, and patient-centered model when applied with structured clinical pathways and patient selection.