A single overnight stay after robotic partial nephrectomy does not increase complications.

Document Type

Article

Publication Date

8-17-2019

Publication Title

Journal of endourology / Endourological Society

Abstract

OBJECTIVE: To evaluate the feasibility of post-operative day 1 (POD1) discharge following robotic partial nephrectomy (RPN) and to determine whether a protocol targeting a shorter length of stay (LOS) is associated with any difference in the rate of post-operative complications.

METHODS: We reviewed a prospectively maintained, multi-institutional database of patients who underwent RPN from September 2013 to September 2016. Three of the six participating surgeons used a protocol that targeted discharge on POD1, while three surgeons did not. Patient characteristics and post-operative complication rates between the two groups were compared.

RESULTS: A total of 665 patients were included, 455 of whom were treated by surgeons utilizing a POD1 discharge protocol while 210 were not. The mean LOS for those in the POD1 protocol group was 1.13 days versus 2.02 in the non-protocol group. Between groups, there were no differences in age (p=.098), body mass index (p=.164), tumor size (p=.502), or R.E.N.A.L. Nephrometry score (p=.974), but POD1 discharge protocol patients had higher age-adjusted Charlson comorbidity score (4 vs 2, p=.033), were less likely to have a hilar tumor (15.9% vs 23.1%, p=.03), and had a larger percent decrease in discharge estimated glomerular filtration rate (-15.9% vs -7.1%, p

CONCLUSION: Discharge on POD1 after RPN is feasible, reproducible by different surgeons, and not associated with an increased risk of post-operative complications.

Clinical Institute

Kidney & Diabetes

Department

Urology

Department

Surgery

Department

Nephrology

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