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Predictors for selection of outpatient single-port robot-assisted laparoscopic radical prostatectomy.
Soputro, Nicolas A; Ramos-Carpinteyro, Roxana; Chavali, Jaya S; Pedraza, Adriana M; Mikesell, Carter D; Kaouk, Jihad.
Afiliación
  • Soputro NA; Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH, USA.
  • Ramos-Carpinteyro R; Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH, USA.
  • Chavali JS; Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH, USA.
  • Pedraza AM; Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH, USA.
  • Mikesell CD; Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH, USA.
  • Kaouk J; Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH, USA.
BJU Int ; 2024 Jul 25.
Article en En | MEDLINE | ID: mdl-39051533
ABSTRACT

OBJECTIVE:

To evaluate the different perioperative variables that may serve as important clinical predictors when selecting patients for outpatient single-port robot-assisted radical prostatectomy (SP-RARP). PATIENTS AND

METHODS:

A retrospective review was performed on the Institutional Review Board-approved, prospectively maintained database to identify 485 consecutive patients who underwent SP-RARP between 2018 and 2023. A comparison analysis was performed on patients who were managed as outpatients vs inpatients following their respective SP-RARP. A separate analysis was performed after excluding patients with pre-planned admissions to identify the risk factors for unplanned admissions.

RESULTS:

All procedures were successfully completed without any conversion or additional ports. After excluding patients with pre-planned admissions, outpatient SP-RARP was successfully achieved in 86.6% with a median (interquartile range) length of stay of 4.6 (3.8-6.1) hours. Our multivariate regression analysis identified cardiac comorbidity and preoperative International Prostate Symptom Score (IPSS) as predictors of outpatient SP-RARP. In addition, the absence of cardiac comorbidity, previous abdominal surgery, and lower postoperative pain score were protective against the risk of unplanned admission. Furthermore, both inpatient and outpatient encounters had comparable 90-day rates of postoperative complication (P = 0.136) and hospital re-admission (P = 0.942).

CONCLUSION:

Outpatient management models could be successfully achieved in most patients who underwent SP-RARP (86.6%) while maintaining similarly low perioperative morbidity profile. Nevertheless, appropriate patient selection based on the baseline clinicodemographic characteristics remains essential to ensure the safety and ongoing success of outpatient SP-RARP.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: BJU Int Asunto de la revista: UROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: BJU Int Asunto de la revista: UROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido