Abstract
Since its inception, robot-assisted radical prostatectomy (RARP) has developed into a familiar surgical modality with improved perioperative outcomes including decreased hospital stay for localized prostate cancer patients. Experience with outpatient RARP has been reported as early as 2010. In this study, we evaluate the safety and feasibility of outpatient RARP by comparing perioperative outcomes between patients undergoing outpatient RARP to patients discharged on the day following surgery. This is a single-institution retrospective cohort study. Patients with localized disease who underwent RARP without pelvic lymph node dissection from September 2017 to January 2018 were included. T tests and Chi-squared analysis were used to compare demographic and perioperative characteristics of patients who were discharged on the same day of surgery (outpatient RARP) to patients discharged on the day after surgery (inpatient RARP). Of the 51 patients included in the study, 26 underwent outpatient RARP while 25 underwent inpatient RARP. There was no significant difference in mean age (61.4 vs 65.8 years, p = 0.05), BMI (27.1 vs 28.3 kg/m2, p = 0.35), ethnicity, tobacco use (8 vs 15%, p = 0.41), PSA (8.7 vs 8.4 ng/dL, p = 0.77), biopsy Gleason score distribution, prostate size (51.8 vs 57.7 cc, p = 0.26) or preoperative hemoglobin (14.3 vs 13.4 g/dL, p = 0.06), respectively. There was no significant difference between operative time (95.3 vs 101 min, p = 0.16), EBL (52.8 vs 66.5 cc, p = 0.08), postoperative change in hemoglobin (− 1 vs − 1.1 g/dL, p = 0.62), pathologic stage distribution or complication rate (4 vs 8%, p = 0.58) between patients who underwent outpatient vs inpatient RARP, respectively. Outpatient RARP offers similar or improved perioperative outcomes when compared to inpatient RARP. We advocate outpatient RARP as a safe and feasible alternative to inpatient RARP for appropriately selected prostate cancer patients. Furthermore, we introduce an outpatient model that can be applied to other institutions seeking to implement outpatient RARP.
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References
Martin AD, Nunez RN, Andrews JR et al (2010) Outpatient prostatectomy: too much too soon or just what the patient ordered. Urology 75(2):421–424
Berger AK, Chopra S, Desai MM et al (2016) Outpatient robotic radical prostatectomy: matched-pair comparison with inpatient surgery. J Endourol 30:50–54
Seisen T, Cole AP, Sun M et al (2017) Assessing robot-assisted laparoscopic prostatectomy. Lancet 389(10071):799
Luciani LG, Mattevi D, Mantovani W et al (2017) Retropubic, laparoscopic and robot-assisted radical prostatectomy: a comparative analysis of the surgical outcomes in a single regional center. Curr Urol 11(1):36–41
Basiri A, de la Rosette JJ, Tabatabaei S et al (2018) Comparison of retropubic, laparoscopic and robotic radical prostatectomy: who is the winner? World J Urol 36(4):609–621
Ploussard S (2018) Robotic surgery in urology: facts and reality. What are the real advantages of robotic approaches for prostate cancer patients? Curr Opin Urol 28(2):153–158
Abboudi H, Doyle P, Winkler M (2017) Day case laparoscopic radical prostatectomy. Arch Ital Urol Androl 89(3):182–185
Guinn NR, Broomer BW, White W et al (2013) Comparison of visually estimated blood loss with direct hemoglobin measurement in multilevel spine surgery. Transfusion 53:2790
Lopez-Picado A, Albinarrate A, Barrachina B (2017) Determination of perioperative blood loss: accuracy or approximation? Anesth Analg 125:280
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Pooya Banapour, Peter Elliott, Ramzi Jabaji, Madhur Merchant, Apurba Pathak, Ashish Parekh and Kirk Tamaddon declare that they have no conflict of interest.
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Banapour, P., Elliott, P., Jabaji, R. et al. Safety and feasibility of outpatient robot-assisted radical prostatectomy. J Robotic Surg 13, 261–265 (2019). https://doi.org/10.1007/s11701-018-0848-8
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DOI: https://doi.org/10.1007/s11701-018-0848-8