Outpatient vs Inpatient Robot-Assisted Radical Prostatectomy: An Evidence-Based Analysis of Comparative Outcomes

Purpose: To provide a systematic analysis of outcomes comparing outpatient and inpatient robot-assisted radical prostatectomy (RARP) for prostate cancer based on the best available evidence. Methods: A comprehensive search of electronic databases (PubMed, Web of Science, Scopus, and Cochrane Library) was conducted to determine eligible comparative studies as of July 2021. The Newcastle-Ottawa scale was used to assess the quality of the included studies. Parameters including perioperative, oncologic, and functional outcomes were collected. Results: Nine studies with 2721 patients were included, of which 831 underwent outpatient RARP and 1890 underwent inpatient RARP. The combined results demonstrated that compared with the inpatient group, the outpatient group had shorter operation time (weighted mean difference −8.59, 95% confidence interval [CI] −14.08 to −3.10, p = 0.002) and lower overall complication rate (odds ratio 0.64, 95% CI 0.44 to 0.95, p = 0.03). However, there were no significant differences regarding estimated blood loss, readmission rate, positive surgical margin, and urinary continence rates between the groups. Conclusions: Outpatient RARP does not increase the incidence of complications and readmissions compared with inpatient RARP. This suggests that routine same-day discharge after providing patients with RARP is safe and feasible.