Assessment of routine same-day discharge surgery for robot-assisted radical prostatectomy

被引:5
作者
Broe, Mark [1 ]
Carbin Joseph, Danny Darlington [1 ]
Casson, Helen [1 ]
Innes, Maria [1 ]
Adamou, Constantinos [1 ]
Fragkoulis, Gerasimos [1 ]
Moschonas, Dimitrios [1 ]
Kusuma, Venkata Ramana Murthy [1 ]
Hicks, James [1 ]
Patil, Krishna [1 ]
Perry, Matthew James Alexander [1 ]
Abou Chedid, Wissam [1 ]
机构
[1] Royal Surrey Cty Hosp, Stokes Ctr Urol, Dept Urol, Egerton Rd, Guildford GU2 7XX, Surrey, England
关键词
Day-case; Day of surgery discharge; Same-day discharge; Robotic-assisted radical prostatectomy; RARP; Robotic surgery; LYMPH-NODE DISSECTION; IMPACT; CANCER; COST;
D O I
10.1007/s00345-023-04566-x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Introduction It is important for robotic surgery to be cost-effective, especially by reducing the length of stay (LOS). Therefore, we developed a protocol for day-case robot-assisted radical prostatectomy (RARP). This study aimed to validate this as a safe practice of care and to assess the potential benefits to the hospital and patient. Methods In this single-centre study, all patients booked for RARP between April 2022 and October 2022 were screened for suitability for day case. All tumour types were included. Exclusion criteria were a history of complex abdominal surgeries, salvage prostatectomy, body mass index (BMI)>35 and patient living alone or>150 km away from the hospital. All day-case RARPs were performed as a morning case with a protocol for review throughout the day with evening discharge if mobilising independently and eating/drinking well. The primary outcome of the study was success rate of discharge home on day of surgery (DOS) with secondary outcomes of readmissions and complications. A patient questionnaire was completed at home including both visual analogue scale (VAS) for pain and satisfaction rating. Results Forty-five patients underwent day-case RARP over a 6-month period with minimum of 30 days of follow-up. 41/45 (91%) had successful DOS discharge home. The four admissions overnight were due to dizziness, low oxygen saturation, intraoperative complications and a diagnosis of COVID-19. There were no readmissions and no 30-day complications. The most common issues at home were catheter discomfort and constipation with low mean VAS pain score and low nausea reported. The overall patient satisfaction rating was very high at 4.8/5, and 97% said they would recommend to a family member. The cost saving for the hospital was 400 pounds per patient. Conclusion Day-case procedure is a viable, safe and efficient pathway for appropriately selected and counselled patients undergoing RARP.
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页码:2679 / 2684
页数:6
相关论文
共 20 条
[1]   Same Day Discharge after Robotic Radical Prostatectomy [J].
Abaza, Ronney ;
Martinez, Oscar ;
Ferroni, Matthew C. ;
Bsatee, Aya ;
Gerhard, Robert S. .
JOURNAL OF UROLOGY, 2019, 202 (05) :961-965
[2]   Assessing the cost effectiveness of robotics in urological surgery - a systematic review [J].
Ahmed, Kamran ;
Ibrahim, Amel ;
Wang, Tim T. ;
Khan, Nuzhath ;
Challacombe, Ben ;
Khan, Muhammed Shamim ;
Dasgupta, Prokar .
BJU INTERNATIONAL, 2012, 110 (10) :1544-1556
[3]   Ambulatory Robot-Assisted Laparoscopic Prostatectomy: Is It Ready for Prime Time? A Quality of Life Analysis [J].
Bajpai, Rajesh Raj ;
Razdan, Shirin ;
Barack, Justin ;
Sanchez, Marcos A. ;
Razdan, Sanjay .
JOURNAL OF ENDOUROLOGY, 2019, 33 (10) :814-822
[4]   The Cost of Quarantine Projecting the Financial Impact of Canceled Elective Surgery on the Nation's Hospitals [J].
Bose, Sourav K. ;
Dasani, Serena ;
Roberts, Sanford E. ;
Wirtalla, Chris ;
DeMatteo, Ronald P. ;
Doherty, Gerard M. ;
Kelz, Rachel R. .
ANNALS OF SURGERY, 2021, 273 (05) :844-849
[5]   Impact of Pelvic Lymph Node Dissection and Its Extent on Perioperative Morbidity in Patients Undergoing Radical Prostatectomy for Prostate Cancer: A Comprehensive Systematic Review and Meta-analysis [J].
Cacciamani, Giovanni E. ;
Maas, Marissa ;
Nassiri, Nima ;
Ortega, David ;
Gill, Karanvir ;
Dell'Oglio, Paolo ;
Thalmann, George N. ;
Heidenreich, Axel ;
Eastham, James A. ;
Evans, Christopher P. ;
Karnes, R. Jeffrey ;
Abreu, Andre L. De Castro ;
Briganti, Alberto ;
Artibani, Walter ;
Gill, Inderbir ;
Montorsi, Francesco .
EUROPEAN UROLOGY ONCOLOGY, 2021, 4 (02) :134-149
[6]   Robot-assisted radical prostatectomy versus standard laparoscopic radical prostatectomy: an evidence-based analysis of comparative outcomes [J].
Carbonara, Umberto ;
Srinath, Maya ;
Crocerossa, Fabio ;
Ferro, Matteo ;
Cantiello, Francesco ;
Lucarelli, Giuseppe ;
Porpiglia, Francesco ;
Battaglia, Michele ;
Ditonno, Pasquale ;
Autorino, Riccardo .
WORLD JOURNAL OF UROLOGY, 2021, 39 (10) :3721-3732
[7]   Outpatient Robot-Assisted Radical Prostatectomy: Are Patients Ready for Same-Day Discharge? [J].
Dobbs, Ryan W. ;
Thanh-Tuan Nguyen ;
Shahait, Mohammed ;
Lee, Daniel J. ;
Kim, Jessica L. ;
El-Fahmawi, Ayah ;
Lee, David, I .
JOURNAL OF ENDOUROLOGY, 2020, 34 (04) :450-455
[8]   The Benefits and Harms of Different Extents of Lymph Node Dissection During Radical Prostatectomy for Prostate Cancer: A Systematic Review [J].
Fossati, Nicola ;
Willemse, Peter-Paul M. ;
Van den Broeck, Thomas ;
van den Bergh, Roderick C. N. ;
Yuan, Cathy Yuhong ;
Briers, Erik ;
Bellmunt, Joaquim ;
Bolla, Michel ;
Cornford, Philip ;
De Santis, Maria ;
MacPepple, Ekelechi ;
Henry, Ann M. ;
Mason, Malcolm D. ;
Matveev, Vsevolod B. ;
van der Poel, Henk G. ;
van der Kwast, Theo H. ;
Rouviere, Olivier ;
Schoots, Ivo G. ;
Wiegel, Thomas ;
Lam, Thomas B. ;
Mottet, Nicolas ;
Joniau, Steven .
EUROPEAN UROLOGY, 2017, 72 (01) :84-109
[9]   Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patients [J].
Hunger, Richard ;
Konig, Volker ;
Stillger, Rosi ;
Mantke, Rene .
PATIENT SAFETY IN SURGERY, 2022, 16 (01)
[10]   Outpatient Prostatectomy: Too Much Too Soon or Just What the Patient Ordered [J].
Martin, Aaron D. ;
Nunez, Rafael N. ;
Andrews, Jack R. ;
Martin, George L. ;
Andrews, Paul E. ;
Castle, Erik P. .
UROLOGY, 2010, 75 (02) :421-424