First Canadian experience with same-day discharge after robot-assisted radical prostatectomy

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Robot-assisted radical prostatectomy (RARP) is a common procedure.
• Evaluating same-day discharge (SDD) protocols for RARP is crucial for optimizing patient care and hospital resources.

Purpose of the Study:

• To assess the feasibility and safety of implementing a same-day discharge (SDD) protocol for patients undergoing robot-assisted radical prostatectomy (RARP) and pelvic lymph node dissection.

Main Methods:

• A prospective cohort study was conducted in 2021, comparing patients on an SDD RARP protocol with traditional inpatient (IP-RARP) care.
• Statistical analyses included t-tests, Mann-Whitney U tests, and multiple logistic regression to identify predictors of successful same-day discharge.

Main Results:

• Of 57 patients on the SDD pathway, 33 (58%) were successfully discharged the same day.
• No significant differences were observed in emergency department visits or hospital admissions between SDD and IP-RARP cohorts.
• The first case of the day was the only significant predictor of successful same-day discharge (OR 4.08).

Conclusions:

• Implementing a same-day discharge pathway for RARP is feasible.
• The SDD protocol for RARP does not lead to an increased rate of complications, unscheduled visits, or readmissions.
• This approach supports efficient patient management without compromising safety.