Feasibility and safety of hospital discharge 24 hours after laparoscopic radical prostatectomy

OBJECTIVES: Minimally invasive techniques for the surgical treatment of prostate cancer have aimed to achieve the same functional and oncological outcomes of open surgery with a significant decrease in postoperative morbidity and a subsequent decreasing hospital stay These improvements are important in the current economic context. Our aim was to evaluate the feasibility and safety of hospital discharge 24 h after laparoscopic radical prostatectomy (LRP). METHODS : A total of 266 consecutive patients with clinical diagnosis of localized prostate cancer consecutively treated with extraperitoneal LRP between May 2007 and December 2010 were analyzed. There were no exclusion criteria for the surgical procedure. Patients were discharged in less than 24 h only in the case of absence of medical complications, with drainage of less than 50 mL allowing its removal before discharge, normal oral feeding tolerance, no significant hematuria by bladder catheter and good functional recovery of the patient. All surgery-related complications that occurred within 90 days after surgery were recorded and were classified according to the modified Clavien scale. RESULTS : A total of 266 patients who underwent LRP were studied with a median follow-up of 34 months. 80 (30.1%) patients were discharged from the hospital in less than 24h. 89 (33.4%) patients were discharged within 48 h and 97 (36.5 %) after 48h. The mean hospital stay of the entire case series was 2.9 days (SD 3.08). The mean hospital stay of patients who were discharged after 48h was 5,5 days (SD 3.94). Thirty-one patients (10.7%) experienced post-surgical complications. 25 (9.3%) of them were classified as Clavien I or II, and 6 (2.2%) Clavien III or IV. A total of 9 (3.3%) patients were readmitted. Of the group of patients who were discharged within 24h only one was readmitted due to hematuria. CONCLUSIONS: Extraperitoneal LRP is the standard treatment for localized prostate cancer in our institution. This treatment reliably and safely allows a hospital stay shorter than 24 h in a significant percentage of our patients.