Same-Day Discharge Protocol for Robot-Assisted Radical Prostatectomy: Experience of a High-Volume Referral Center

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• The COVID-19 pandemic necessitates strategies to minimize patient exposure to healthcare settings.
• Same-day discharge (SDD) protocols can reduce viral exposure for oncologic patients undergoing surgery.
• Robot-assisted radical prostatectomy (RARP) is a common procedure for prostate cancer treatment.

Purpose of the Study:

• To prospectively analyze the outcomes of a same-day discharge (SDD) protocol for patients undergoing robot-assisted radical prostatectomy (RARP).
• To evaluate the safety and feasibility of SDD in the context of the COVID-19 pandemic.
• To identify factors influencing successful SDD after RARP.

Main Methods:

• Prospective analysis of 101 patients meeting strict SDD criteria after RARP.
• Exclusion criteria included advanced age, comorbidities, and complex procedures.
• Outcomes assessed included successful discharge, readmission rates, complications, and pain scores.

Main Results:

• 72% (73/101) of selected patients achieved effective same-day discharge.
• No significant differences in readmission rates, complications, or pain scores between SDD and same-day discharge failure (SDF) groups.
• Common reasons for SDF included anesthesia-related factors (nausea, drowsiness), pain, and patient preference.

Conclusions:

• Same-day discharge (SDD) is a safe and feasible clinical pathway for select patients undergoing robot-assisted radical prostatectomy (RARP).
• Careful patient selection and coordinated multidisciplinary care are crucial for successful SDD implementation.
• Pre- and postoperative patient education is vital to enhance confidence and minimize COVID-19 exposure during prostate cancer treatment.