Successful Same-Day Discharge for Robot-Assisted Radical Prostatectomy: A Systematic Review and Meta-analysis

No AccessUrology PracticeBusiness1 Jul 2022Successful Same-Day Discharge for Robot-Assisted Radical Prostatectomy: A Systematic Review and Meta-AnalysisThis article is commented on by the following:Editorial CommentaryEditorial CommentaryEditorial Commentary Michael Uy, Braden Millan, Conor Jones, David Sands, Edward Matsumoto, Benjamin Bay, and Bobby Shayegan Michael UyMichael Uy https://orcid.org/0000-0001-9426-7360 Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada More articles by this author , Braden MillanBraden Millan Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada More articles by this author , Conor JonesConor Jones Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada More articles by this author , David SandsDavid Sands Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada More articles by this author , Edward MatsumotoEdward Matsumoto Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada Department of Urology, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada More articles by this author , Benjamin BayBenjamin Bay Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada Department of Urology, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada More articles by this author , and Bobby ShayeganBobby Shayegan *Correspondence: Division of Urology, Department of Surgery, McMaster University, 50 Charlton Ave. E, G343 Hamilton, Ontario, Canada L8N4A6 telephone: 905-522-1155, ext. 33982; FAX: 905-308-7210; email address: E-mail Address: [email protected] Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada Department of Urology, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada More articles by this author View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000305AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Introduction: Same-day discharge (SDD) following robot-assisted radical prostatectomy (RARP) is emerging as the standard of care. We conducted a systematic review and meta-analysis to evaluate the differences in perioperative characteristics, complication/readmissions rates and satisfaction/cost data between inpatient (IP) RARP and SDD RARP. Methods: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was prospectively registered with PROSPERO (CRD42021258848). A comprehensive search of PubMed®, Embase®, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and conference abstract publications was performed. A leave-one-out sensitivity analysis was performed to control for heterogeneity and risk of bias. Results: A total of 14 studies were included with a pooled population of 3,795 patients, including 2,348 (61.9%) IP RARPs and 1,447 (38.1%) SDD RARPs. SDD pathways varied, though many commonalities were present in patient selection, perioperative recommendations and postoperative management. When compared to IP RARP, SDD RARP had no differences in ≥grade 3 Clavien–Dindo complications (RR: 0.4, 95% CI 0.2, 1.1, p=0.07), 90-day readmission rates (RR: 0.6, 95% CI 0.3, 1.1, p=0.10) or unscheduled emergency department visits (RR: 1.0, 95% CI 0.3, 3.1, p=0.97). Cost savings per patient ranged between $367 and $2,109, and overall satisfaction was high at 87.5%–100%. Conclusions: SDD following RARP is both feasible and safe, while potentially offering health care cost savings with high patient satisfaction rates. Data from this study will inform the uptake and development of future SDD pathways in contemporary urological care such that it may be offered to a broader patient population. References 1. : Clinical efficacy of enhanced recovery after surgery (ERAS) program in patients undergoing radical prostatectomy: a systematic review and meta-analysis. World J Surg Oncol 2020; 18: 131. 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PROSPERO Protocol No.: CRD42021258848. © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesUrology PracticeMay 12, 2022, 12:00:00 AMEditorial CommentaryUrology PracticeMay 12, 2022, 12:00:00 AMEditorial CommentaryUrology PracticeMay 12, 2022, 12:00:00 AMEditorial Commentary Volume 9Issue 4July 2022Page: 294-305Supplementary Materials Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.Keywordsoutpatientsrobotic surgical proceduressystematic reviewprostatectomyambulatory surgical proceduresMetricsAuthor Information Michael Uy Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada More articles by this author Braden Millan Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada More articles by this author Conor Jones Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada More articles by this author David Sands Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada More articles by this author Edward Matsumoto Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada Department of Urology, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada More articles by this author Benjamin Bay Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada Department of Urology, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada More articles by this author Bobby Shayegan Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada Department of Urology, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada *Correspondence: Division of Urology, Department of Surgery, McMaster University, 50 Charlton Ave. E, G343 Hamilton, Ontario, Canada L8N4A6 telephone: 905-522-1155, ext. 33982; FAX: 905-308-7210; email address: E-mail Address: [email protected] More articles by this author Expand All Support: None. Conflict of Interest: The authors have no conflicts of interest to disclose. Ethics Statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study (systematic review) formal consent is not required. PROSPERO Protocol No.: CRD42021258848. Advertisement PDF DownloadLoading ...