Preoperative Optimization of Promotility in Robotic Prostatectomy and Minimally Invasive Kidney Surgery

Area of Science:

• Oncology
• Surgical Gastroenterology
• Urology

Background:

• Minimally invasive surgery (MIS) for prostate and kidney cancer typically aims for same-day or next-day discharge.
• Gastrointestinal (GI) symptoms frequently cause delays in postoperative discharge.
• The impact of baseline constipation on GI symptoms and discharge delays after MIS is not well understood.

Purpose of the Study:

• To determine the incidence of preoperative constipation in patients undergoing MIS for kidney and prostate cancer.
• To investigate the relationship between baseline constipation and length of stay (LOS) after MIS.

Main Methods:

• A prospective observational study enrolled 97 adult patients undergoing MIS for kidney or prostate cancer.
• Patients completed constipation symptom questionnaires (PAC-SYM) perioperatively.
• Clinicopathological data were collected, and discharge delay (LOS >2 days) was the primary outcome.

Main Results:

• 69% of patients (67/97) reported constipation symptoms preoperatively.
• 18% of patients (17/97) experienced a discharge delay.
• Patients with discharge delays had higher median PAC-SYM scores (4 vs. 2, p=0.021), particularly those with GI symptoms (median PAC-SYM 5, p=0.032).

Conclusions:

• A high prevalence of constipation exists among patients undergoing MIS for urologic cancers.
• Baseline constipation may be a modifiable factor contributing to prolonged hospital stays.
• Preoperative interventions targeting constipation could potentially reduce length of stay after MIS.