Same day discharge for robot-assisted radical prostatectomy: a prospective cohort study documenting an Australian approach.

Mulholland, Clancy; Soliman, Christopher; Furrer, Marc A; Sathianathen, Niranjan; Corcoran, Niall M; Schramm, Belinda; Mertens, Evie; Peters, Justin; Costello, Anthony; Lawrentschuk, Nathan; Dundee, Philip; Thomas, Benjamin (2023). Same day discharge for robot-assisted radical prostatectomy: a prospective cohort study documenting an Australian approach. ANZ journal of surgery, 93(3), pp. 669-674. 10.1111/ans.18198

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BACKGROUND

The introduction of robotic surgical systems has significantly impacted urological surgery, arguably more so than other surgical disciplines. The focus of our study was length of hospital stay - patients have traditionally been discharged day 1 post-robot-assisted radical prostatectomy (RARP), however, during the ongoing COVID-19 pandemic and consequential resource limitations, our centre has facilitated a cohort of same-day discharges with initial success.

METHODS

We conducted a prospective tertiary single-centre cohort study of a series of all patients (n = 28) - undergoing RARP between January and April 2021. All patients were considered for a day zero discharge pathway which consisted of strict inclusion criteria. At follow-up, each patient's perspective on their experience was assessed using a validated post-operative satisfaction questionnaire. Data were reviewed retrospectively for all those undergoing RARP over the study period, with day zero patients compared to overnight patients.

RESULTS

Overall, 28 patients 20 (71%) fulfilled the objective criteria for day zero discharge. Eleven patients (55%) agreed pre-operatively to day zero discharge and all were successfully discharged on the same day as their procedure. There was no statistically significant difference in age, BMI, ASA, Charlson score or disease volume. All patients indicated a high level of satisfaction with their procedure. Median time from completion of surgery to discharge was 426 min (7.1 h) in the day zero discharge cohort.

CONCLUSION

Day zero discharge for RARP appears to deliver high satisfaction, oncological and safety outcomes. Therefore, our study demonstrates early success with unsupported same-day discharge in carefully selected and pre-counselled patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Furrer, Marc

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1445-2197

Language:

English

Submitter:

Pubmed Import

Date Deposited:

25 Jan 2023 13:44

Last Modified:

21 Mar 2023 00:13

Publisher DOI:

10.1111/ans.18198

PubMed ID:

36637213

Uncontrolled Keywords:

ERAS RARP prostate cancer prostatectomy robotic surgical oncology urology

BORIS DOI:

10.48350/177391

URI:

https://boris.unibe.ch/id/eprint/177391

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