A Single Overnight Stay Is Possible for Most Patients Undergoing Robotic Partial Nephrectomy

摘要: Objective To evaluate establishment of overnight stay only as sufficient after robotic partial nephrectomy (RPN). Methods Stated benefits minimally invasive surgery include reduced hospitalization, but published hospital stays laparoscopic or are not significantly less than with open surgery. We developed a clinical pathway targeting discharge on postoperative day (POD) 1 RPN any complexity. reviewed all RPNs by single surgeon since instituting our pathway, including ambulation and diet the night surgery, avoidance intravenous narcotics drains, catheter removal POD before discharge. Targeted was modified regardless Results A total 150 consecutive patients underwent 160 35 hilar tumors 26 segmental, 33 no artery clamping. Three had solitary kidneys, 8 multiple (range, 2-4) RPNs. Mean patient age 57 years 22-89 years), body mass index 32 kg/m 2 18-54 ). tumor size 3.6 cm 1.0-11.0; median, 3.2 cm), RENAL (radius, exophytic/endophytic, nearness to collecting system, anterior/posterior, location) nephrometry score 4-12; 8). warm ischemia time 12.1 minutes 0-30.0 minutes). preoperative creatinine were 0.9 mg/dL 0.43-2.79 mg/dL) 1.13 0.56-2.93 mg/dL). All ambulated 0. One required one dose narcotic. length 1.1 days, 145 (97%) discharged 1, which 4 (2.7%) readmitted within 30 days. Conclusion Discharge is feasible in most Readmission rate low, indicating that longer admissions may prevent complications when meeting criteria go home POD 1.