Single overnight stay after robot-assisted partial nephrectomy: a bi-center experience

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Robot-assisted partial nephrectomy (RAPN) offers shorter hospital stays than open surgery.
• However, reported lengths of stay (LOS) for RAPN often exceed 2-3 days.
• Factors influencing prolonged LOS after RAPN require further investigation.

Purpose of the Study:

• To identify predictors of prolonged hospital stay (≥2 days) following robot-assisted partial nephrectomy (RAPN).
• To assess the feasibility and safety of achieving a single overnight stay after RAPN.

Main Methods:

• Retrospective analysis of 286 patients undergoing RAPN between 2010-2019 at two US centers.
• Patients were categorized into two groups: discharged on postoperative day 1 (POD1) or ≥2 days.
• Multivariable logistic regression identified independent predictors of prolonged LOS.

Main Results:

• 60.5% of patients were discharged on POD1, while 39.5% had LOS ≥2 days.
• Predictors of prolonged LOS included longer operative time (OT) and the occurrence of postoperative complications.
• Patients with shorter LOS had lower mean BMI and were more likely to undergo a retroperitoneal approach.

Conclusions:

• A single overnight stay after RAPN is feasible and safe.
• Prolonged operative time and postoperative complications are associated with increased risk of prolonged hospital stay.
• Optimizing perioperative care pathways can facilitate early discharge without compromising patient safety.