Abstract
Fast-track and day-case surgeries are gaining more and more importance. Their development was eased by the diffusion of minimal invasive surgical strategies and the consequential morbidity reduction. In the field of kidney cancer, seven cases of ambulatory radical nephrectomy were previously reported in the international literature. Regarding robotic partial nephrectomy (PN), short postoperative pathways resulting in patients’ discharge on postoperative day 1 were shown to be safe and feasible. We report our initial experience of robot-assisted PN discharged on postoperative day zero and discuss the criteria for adequate patient selection. Indeed, outpatient PN will obviously not be suitable for all patients, and careful selection will be mandatory. Both specific baseline patient’s factors and postoperative events will have to be recognized for the first ones and prevented for the second ones. Safety, patient satisfaction, cost efficiency, and reproducibility will be the key factors to assess and promote day-case PN.
This is a preview of subscription content, log in via an institution to check access.
References
Ljungberg B, Bensalah K, Bex A et al (2014) Guidelines on renal cell carcinoma. Eur Assoc Urol
King SC, Pollack LA, Li J et al (2014) Continued increase in incidence of renal cell carcinoma, especially in young patients and high grade disease: United States 2001 to 2010. J Urol 191:1665–1670. doi:10.1016/j.juro.2013.12.046
Patard J-J, Baumert H, Bensalah K et al (2013) Recommandations en onco-urologie 2013 du CCAFU: cancer du rein. Prog Urol 23:S177–S204. doi:10.1016/S1166-7087(13)70055-1
Larcher A, Fossati N, Tian Z et al (2015) Prediction of complications following partial nephrectomy: implications for ablative techniques candidates. Eur Urol. doi:10.1016/j.eururo.2015.07.003
Choi JE, You JH, Kim DK et al (2015) Comparison of perioperative outcomes between robotic and laparoscopic partial nephrectomy: a systematic review and meta-analysis. Eur Urol 67:891–901. doi:10.1016/j.eururo.2014.12.028
Brandao LF, Zargar H, Laydner H et al (2014) 30-Day hospital readmission after robotic partial nephrectomy—are we prepared for medicare readmission reduction program? J Urol 192:677–681. doi:10.1016/j.juro.2014.02.009
Autorino R, Zargar H, Butler S et al (2015) Incidence and risk factors for 30-day readmission in patients undergoing nephrectomy procedures: a contemporary analysis of 5276 cases from the national surgical quality improvement program database. Urology 85:843–849. doi:10.1016/j.urology.2014.11.044
Khemees TA, Nasser SM, Abaza R (2014) Clinical pathway after robotic nephroureterectomy: omission of pelvic drain with next-day catheter removal and discharge. Urology 83:818–823. doi:10.1016/j.urology.2013.10.078
Abaza R, Shah K (2013) A single overnight stay is possible for most patients undergoing robotic partial nephrectomy. Urology 81:301–306. doi:10.1016/j.urology.2012.08.067
Mano R, Schulman A, Hakimi AA et al (2015) Cost comparison of open and robotic partial nephrectomy using a short postoperative pathway. Urology 85:596–604. doi:10.1016/j.urology.2014.10.044
Satkunasivam R, Tsai S, Syan S et al (2015) Robotic unclamped “Minimal-margin” partial nephrectomy: ongoing refinement of the anatomic zero-ischemia concept. Eur Urol. doi:10.1016/j.eururo.2015.04.044
Peyronnet B, Baumert H, Mathieu R et al (2014) Early unclamping technique during robot-assisted laparoscopic partial nephrectomy can minimise warm ischaemia without increasing morbidity. BJU Int. doi:10.1111/bju.12766
Peyronnet B, Pradère B, De La Taille A et al (2015) Postoperative drainage does not prevent complications after robotic partial nephrectomy. World J Urol. doi:10.1007/s00345-015-1721-2
Ilie CP, Luscombe CJ, Smith I et al (2011) Day case laparoscopic nephrectomy. J Endourol 25:631–634
Baldini A, Golfier F, Mouloud K et al (2014) Day case laparoscopic nephrectomy with vaginal extraction: initial experience. Urology 84:1525–1528. doi:10.1016/j.urology.2014.06.084
Kutikov A, Uzzo RG (2009) The RENAL nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol 182:844–853. doi:10.1016/j.juro.2009.05.035
Ficarra V, Novara G, Secco S et al (2009) Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol 56:786–793. doi:10.1016/j.eururo.2009.07.040
Rambachan A, Matulewicz RS, Pilecki M et al (2014) Predictors of readmission following outpatient urological surgery. J Urol 192:183–188. doi:10.1016/j.juro.2013.12.053
Kehlet H, Wilmore DW (2002) Multimodal strategies to improve surgical outcome. Am J Surg 183:630–641. doi:10.1016/S0002-9610(02)00866-8
Bernhard J-C, Isotani S, Matsugasumi T et al (2015) Personalized 3D printed model of kidney and tumor anatomy: a useful tool for patient education. World J Urol. doi:10.1007/s00345-015-1632-2
Gornall BF, Myles PS, Smith CL et al (2013) Measurement of quality of recovery using the QoR-40: a quantitative systematic review. Br J Anaesth 111:161–169. doi:10.1093/bja/aet014
Myles PS, Weitkamp B, Jones K et al (2000) Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth 84:11–15. doi:10.1093/oxfordjournals.bja.a013366
Auquier P, Pernoud N, Bruder N et al (2005) Development and validation of a perioperative satisfaction questionnaire. Anesthesiology 102:1116–1123. doi:10.1097/00000542-200506000-00010
Mitropoulos D, Artibani W, Biyani CS et al (2014) quality assessment of partial nephrectomy complications reporting using EAU standardised quality criteria. Eur Urol 66:1–5. doi:10.1016/j.eururo.2014.02.004
Vonlanthen R, Slankamenac K, Breitenstein S et al (2011) The impact of complications on costs of major surgical procedures. Ann Surg 254:907–913. doi:10.1097/SLA.0b013e31821d4a43
Author’s contributions
J.C. Bernhard, A. Payan, and F. Cornelis were helpful in protocol/project development. J.C. Bernhard, G. Pierquet, G. Pasticier, G. Robert, G. Capon, and A Ravaud contributed to data collection or management. J.C. Bernhard and H. Bensadoun analyzed and interpreted the data. J.C. Bernhard, H. Bensadoun, and J.M. Ferrière prepared the manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interests.
Ethical standard
The clinical data reported were collected within the framework of the UroCCR project that is IRB-approved and obtained the CNIL authorization number DR-2013-206. All patients receive oral information about the objectives and methodology of the UroCCR project, and informed written consent is obtained from all participants before inclusion.
Rights and permissions
About this article
Cite this article
Bernhard, JC., Payan, A., Bensadoun, H. et al. Are we ready for day-case partial nephrectomy?. World J Urol 34, 883–887 (2016). https://doi.org/10.1007/s00345-015-1746-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-015-1746-6