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

By: Michael Uy, MD; Braden Millan, MSc, MD; Conor Jones, MD; David Sands, MD; Edward Matsumoto, MD, MEd, FRCSC; Benjamin Bay, MD, FRCSC; Bobby Shayegan, MD, FRCSC | Posted on: 01 Jul 2022

Uy M, Millan B, Jones C et al: Successful same-day discharge for robot-assisted radical prostatectomy: a systematic review and meta-analysis. Urol Pract 2022; 9: 294.

Study Need and Importance

Same-day discharge (SDD) following robot-assisted radical prostatectomy (RARP) is emerging as a standard of care. The results of this systematic review and meta-analysis can be utilized for the development of future SDD pathways in centers moving toward an ambulatory RARP model.

“SDD following RARP is both feasible and safe, and likely will become the standard of care in contemporary urological care.”
Figure. Meta-analysis of complications between SDD and inpatient (IP) RARP. A, total complications. B, Clavien-Dindo grade 3 complications. C, 90-day readmission rate. M-H, multi-hazard.

What We Found

SDD following RARP is both feasible and safe, with comparable complication and readmission rates when compared to inpatient RARP (see Figure). Additionally, SDD may offer potential health care cost savings with high patient satisfaction rates. Within the paper, we summarized all available SDD protocols to assist in the development of future pathways.

Limitations

Study evidence was not obtained from randomized control trials. Furthermore, studies included were published in the United States and France, and therefore these results may not be generalizable to other countries.

Interpretation for Patient Care

SDD following RARP is both feasible and safe, and likely will become the standard of care in contemporary urological care. This ambulatory model may have benefits in health care cost savings while maintaining high patient satisfaction rates, though this may vary based on country of implementation.