Abstract
OBJECTIVE
To evaluate the feasibility and safety of performing robotic-assisted laparoscopic
partial nephrectomy (RAPN) as outpatient surgery in patients with renal masses.
MATERIALS AND METHODS
We analyzed RAPN performed by a single surgeon at an academic medical center from
July 2018 to June 2019 and identified those individual patients who were discharged
on the same day. These cases were then compared to a concurrent inpatient RAPN group.
Relationships with outcome analyzed using Fisher's exact test and Student's t test.
RESULTS
Twenty-three of 84 RAPNs (27.4%) were performed as ambulatory. Mean age was 57.4 years.
Average tumor size was 2.24 cm. The mean total operative time was 99.4 minutes. Average
estimated blood loss was 51.0 mL. When compared to the cohort of patients who stayed
overnight, on multivariate analysis, the tumor size (2.24 ± 0.71 vs 3.65 ± 1.55 cm,
P <0.001), and operative time (99.5 ± 25.1 vs 131.2 ± 30.8 minutes, P <0.001) were less in ambulatory cases. No differences were seen in regards to Charlson
comorbidity index, age, gender, body mass index, estimated blood loss, or surgical
approach. Within 90 days of postoperative period, the readmission rate for the entire
cohort was 0.
CONCLUSION
RAPN can be performed safely as ambulatory in select patients with comparable outcome
without complication or hospital readmission.
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Article info
Publication history
Published online: May 27, 2020
Accepted:
April 5,
2020
Received:
February 7,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
