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A Single Overnight Stay After Robotic Partial Nephrectomy Does Not Increase Complications.

Katherine T Sentell1, Ketan K Badani2, David J Paulucci2

  • 1OhioHealth Robotic Urologic and Cancer Surgery, Dublin Methodist Hospital, Dublin, Ohio.

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Summary

Discharging patients on postoperative day 1 (POD1) after robotic partial nephrectomy (RPN) is feasible. This shorter length of stay protocol does not increase the risk of complications.

Keywords:
complicationslength of stayovernight stayrobotic partial nephrectomysocioeconomics

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrology

Background:

  • Robotic partial nephrectomy (RPN) is a standard treatment for kidney tumors.
  • Optimizing patient recovery and length of stay (LOS) is crucial for healthcare efficiency.
  • Assessing the safety and feasibility of early discharge protocols is essential.

Purpose of the Study:

  • To evaluate the feasibility of same-day discharge (postoperative day 1 - POD1) after RPN.
  • To determine if a protocol for shorter LOS impacts postoperative complication rates.

Main Methods:

  • A multi-institutional review of a prospectively maintained database of RPN patients (September 2013-September 2016).
  • Comparison of patient characteristics and complication rates between surgeons using a POD1 discharge protocol and those not using one.
  • Analysis of 665 patients, with 455 in the POD1 protocol group and 210 in the non-protocol group.

Main Results:

  • The POD1 protocol group had a significantly shorter mean LOS (1.13 days vs. 2.02 days).
  • No significant differences in overall, major, medical, or surgical complication rates were observed between the groups.
  • Patients in the POD1 group had a higher comorbidity score and a greater decrease in estimated glomerular filtration rate, but still tolerated early discharge safely.

Conclusions:

  • Postoperative day 1 discharge after RPN is a feasible and reproducible strategy.
  • Implementing a POD1 discharge protocol does not elevate the risk of postoperative complications.
  • Early discharge can be safely achieved without compromising patient safety or increasing complication rates.