First Canadian experience with same-day discharge after robotassisted radical prostatectomy

Authors

  • Braden Millan Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
  • Raees Cassim Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
  • Michael Uy Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
  • Benjamin Bay Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
  • Bobby Shayegan Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

DOI:

https://doi.org/10.5489/cuaj.7914

Keywords:

robot-assisted radical prostatectomy, same-day discharge, prostate cancer

Abstract

INTRODUCTION: We aimed to evaluate the feasibility and safety of implementing a same-day discharge (SDD) protocol for robot-assisted radical prostatectomy (RARP) and pelvic lymph node dissection.

METHODS: We performed a prospective cohort study including all consecutive eligible patients undergoing RARP in 2021 following initiation of SDD RARP protocol in April. Baseline characteristics were compared using t-tests, Mann-Whitney U tests, and odds ratios (OR) calculated using multiple logistic regression to assess for predictors of SDD success.

RESULTS: A total of 117 patients underwent RARP in 2021 following initiation of the SDD protocol. Fifty-seven patients were initiated on the SDD pathway and 60 patients underwent surgery as an inpatient (IP-RARP). Of those on the SDD pathway (SDD-RARP), 33 (58%) were successfully discharged the same day of surgery, while 24 (42%) failed SDD. Baseline demographics were well-balanced between cohorts. Case order, increased patient age, and distance travelled to the hospital were factors associated with selection of patients for the IP-RARP protocol. In total, 12 SDD and 12 IP patients presented to the emergency department (p=1.0), and none within 24 hours of discharge. There were no hospital admissions in the SDD cohort, with four readmissions in the IP cohort (p=0.1). Multiple logistic regression revealed that case order (first case) was the only predictive factor for SDD success (OR 4.08, 95% confidence interval 1.59–11.62, p=0.005).

CONCLUSIONS: Implementation of an SDD pathway following RARP is feasible, with no increase in rates of complications, unscheduled visits, or readmissions.

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Published

2022-09-30

How to Cite

Millan, B., Cassim, R., Uy, M., Bay, B., & Shayegan, B. (2022). First Canadian experience with same-day discharge after robotassisted radical prostatectomy. Canadian Urological Association Journal, 17(2), 39–43. https://doi.org/10.5489/cuaj.7914

Issue

Vol. 17 No. 2 (2023): CUAJ February

Section

Original Research

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