Cargando…

Same Day Discharge versus Inpatient Surgery for Robot-Assisted Radical Prostatectomy: A Comparative Study

(1) Background: no study has compared outcomes of same day discharge (SDD) versus inpatient robot-assisted radical prostatectomy (RARP) in homogenous cohorts. Our aim was to compare perioperative outcomes and urinary continence recovery between SDD and inpatient RARP in contemporary, comparable pati...

Descripción completa

Detalles Bibliográficos
Autores principales: Rahota, Razvan George, Salin, Ambroise, Gautier, Jean Romain, Almeras, Christophe, Loison, Guillaume, Tollon, Christophe, Beauval, Jean Baptiste, Ploussard, Guillaume
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914654/
https://www.ncbi.nlm.nih.gov/pubmed/33572174
http://dx.doi.org/10.3390/jcm10040661
_version_ 1783657054022402048
author Rahota, Razvan George
Salin, Ambroise
Gautier, Jean Romain
Almeras, Christophe
Loison, Guillaume
Tollon, Christophe
Beauval, Jean Baptiste
Ploussard, Guillaume
author_facet Rahota, Razvan George
Salin, Ambroise
Gautier, Jean Romain
Almeras, Christophe
Loison, Guillaume
Tollon, Christophe
Beauval, Jean Baptiste
Ploussard, Guillaume
author_sort Rahota, Razvan George
collection PubMed
description (1) Background: no study has compared outcomes of same day discharge (SDD) versus inpatient robot-assisted radical prostatectomy (RARP) in homogenous cohorts. Our aim was to compare perioperative outcomes and urinary continence recovery between SDD and inpatient RARP in contemporary, comparable patients. (2) Methods: we included consecutive patients undergoing RARP between 2018 and 2020 (n = 376). Only patients eligible for SDD (no oral anticoagulant, distance home-hospital <150 km) and having >6-month follow-up were included (n = 180). All patients underwent RARP with or without lymph node dissection. Comparisons were performed between SDD (n = 42) and inpatient RARP (n = 138). Primary outcomes were 90-day complication and readmission rates and continence rates at 1 and 6 months. (3) Results: median patient age was 66.7 years. Median duration of surgery and blood loss was 134 min and 200 mL, respectively. Lymph node dissection and nerve-sparing procedures were performed in 76.7% and 82.2% of cases, respectively. Median follow-up was 19.5 months. No difference was seen regarding patient features, peri-operative outcomes, and pathology parameters between both groups. The proportion of SDD RARP was stable over time (23.5%). The 90-day unplanned visits, readmission and complication rates were 9.5%, 7.1%, and 19.0% in SDD patients versus 14.5% (p = 0.407), 10.1% (p = 0.560), 28.3% (p = 0.234) for inpatient RARP, respectively. Trends favoring SDD were not statistically significant. Continence rates at 1-(p = 0.589) and 6-months (p = 0.674) were comparable between SDD and inpatient RARP. The main limitation was the lack of randomization. (4) Conclusions: this multi-surgeon comparative study confirms the safety of routine SDD RARP in terms of perioperative and functional outcomes. Trends favoring SDD in terms of complications, emergency visits and readmission have to be confirmed.
format Online
Article
Text
id pubmed-7914654
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-79146542021-03-01 Same Day Discharge versus Inpatient Surgery for Robot-Assisted Radical Prostatectomy: A Comparative Study Rahota, Razvan George Salin, Ambroise Gautier, Jean Romain Almeras, Christophe Loison, Guillaume Tollon, Christophe Beauval, Jean Baptiste Ploussard, Guillaume J Clin Med Article (1) Background: no study has compared outcomes of same day discharge (SDD) versus inpatient robot-assisted radical prostatectomy (RARP) in homogenous cohorts. Our aim was to compare perioperative outcomes and urinary continence recovery between SDD and inpatient RARP in contemporary, comparable patients. (2) Methods: we included consecutive patients undergoing RARP between 2018 and 2020 (n = 376). Only patients eligible for SDD (no oral anticoagulant, distance home-hospital <150 km) and having >6-month follow-up were included (n = 180). All patients underwent RARP with or without lymph node dissection. Comparisons were performed between SDD (n = 42) and inpatient RARP (n = 138). Primary outcomes were 90-day complication and readmission rates and continence rates at 1 and 6 months. (3) Results: median patient age was 66.7 years. Median duration of surgery and blood loss was 134 min and 200 mL, respectively. Lymph node dissection and nerve-sparing procedures were performed in 76.7% and 82.2% of cases, respectively. Median follow-up was 19.5 months. No difference was seen regarding patient features, peri-operative outcomes, and pathology parameters between both groups. The proportion of SDD RARP was stable over time (23.5%). The 90-day unplanned visits, readmission and complication rates were 9.5%, 7.1%, and 19.0% in SDD patients versus 14.5% (p = 0.407), 10.1% (p = 0.560), 28.3% (p = 0.234) for inpatient RARP, respectively. Trends favoring SDD were not statistically significant. Continence rates at 1-(p = 0.589) and 6-months (p = 0.674) were comparable between SDD and inpatient RARP. The main limitation was the lack of randomization. (4) Conclusions: this multi-surgeon comparative study confirms the safety of routine SDD RARP in terms of perioperative and functional outcomes. Trends favoring SDD in terms of complications, emergency visits and readmission have to be confirmed. MDPI 2021-02-09 /pmc/articles/PMC7914654/ /pubmed/33572174 http://dx.doi.org/10.3390/jcm10040661 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rahota, Razvan George
Salin, Ambroise
Gautier, Jean Romain
Almeras, Christophe
Loison, Guillaume
Tollon, Christophe
Beauval, Jean Baptiste
Ploussard, Guillaume
Same Day Discharge versus Inpatient Surgery for Robot-Assisted Radical Prostatectomy: A Comparative Study
title Same Day Discharge versus Inpatient Surgery for Robot-Assisted Radical Prostatectomy: A Comparative Study
title_full Same Day Discharge versus Inpatient Surgery for Robot-Assisted Radical Prostatectomy: A Comparative Study
title_fullStr Same Day Discharge versus Inpatient Surgery for Robot-Assisted Radical Prostatectomy: A Comparative Study
title_full_unstemmed Same Day Discharge versus Inpatient Surgery for Robot-Assisted Radical Prostatectomy: A Comparative Study
title_short Same Day Discharge versus Inpatient Surgery for Robot-Assisted Radical Prostatectomy: A Comparative Study
title_sort same day discharge versus inpatient surgery for robot-assisted radical prostatectomy: a comparative study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914654/
https://www.ncbi.nlm.nih.gov/pubmed/33572174
http://dx.doi.org/10.3390/jcm10040661
work_keys_str_mv AT rahotarazvangeorge samedaydischargeversusinpatientsurgeryforrobotassistedradicalprostatectomyacomparativestudy
AT salinambroise samedaydischargeversusinpatientsurgeryforrobotassistedradicalprostatectomyacomparativestudy
AT gautierjeanromain samedaydischargeversusinpatientsurgeryforrobotassistedradicalprostatectomyacomparativestudy
AT almeraschristophe samedaydischargeversusinpatientsurgeryforrobotassistedradicalprostatectomyacomparativestudy
AT loisonguillaume samedaydischargeversusinpatientsurgeryforrobotassistedradicalprostatectomyacomparativestudy
AT tollonchristophe samedaydischargeversusinpatientsurgeryforrobotassistedradicalprostatectomyacomparativestudy
AT beauvaljeanbaptiste samedaydischargeversusinpatientsurgeryforrobotassistedradicalprostatectomyacomparativestudy
AT ploussardguillaume samedaydischargeversusinpatientsurgeryforrobotassistedradicalprostatectomyacomparativestudy