Same Day Discharge versus Inpatient Surgery for Robot-Assisted Radical Prostatectomy: A Comparative Study

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• No prior studies compared outcomes of same-day discharge (SDD) versus inpatient robot-assisted radical prostatectomy (RARP) in homogenous cohorts.
• Contemporary, comparable patients undergoing RARP were analyzed to compare perioperative outcomes and urinary continence recovery.

Purpose of the Study:

• To compare perioperative outcomes and urinary continence recovery between same-day discharge (SDD) and inpatient robot-assisted radical prostatectomy (RARP).

Main Methods:

• A cohort of 376 patients undergoing RARP between 2018-2020 was analyzed, with 180 eligible for SDD criteria (no oral anticoagulants, home-hospital distance <150 km) and >6-month follow-up.
• Comparisons were made between SDD (n=42) and inpatient RARP (n=138) regarding 90-day complication/readmission rates and 1/6-month continence rates.

Main Results:

• No significant differences were observed in patient demographics, perioperative outcomes, or pathology between SDD and inpatient RARP groups.
• 90-day unplanned visits, readmission, and complication rates showed non-significant trends favoring SDD (9.5%, 7.1%, 19.0% vs 14.5%, 10.1%, 28.3%).
• Urinary continence rates at 1 and 6 months were comparable between both groups (p > 0.5).

Conclusions:

• This multi-surgeon study supports the safety of routine same-day discharge robot-assisted radical prostatectomy regarding perioperative and functional outcomes.
• While trends favored SDD for complications and readmissions, further research is needed to confirm these findings.
• The primary limitation identified was the lack of patient randomization.