Hakan Bahadir Haberal, Luca Lambertini, Matteo Pacini, Giulio Avesani, Fabio Maria Valenzi, Muhannad Aljoulani, Ruben Calvo Sauer, Juan Ramon Torres-Anguiano, Simone Crivellaro
{"title":"Trifecta of Same-Day Discharge after Single-Port Robotic-Assisted Simple Prostatectomy.","authors":"Hakan Bahadir Haberal, Luca Lambertini, Matteo Pacini, Giulio Avesani, Fabio Maria Valenzi, Muhannad Aljoulani, Ruben Calvo Sauer, Juan Ramon Torres-Anguiano, Simone Crivellaro","doi":"10.1089/end.2024.0930","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Introduction:</i></b> There are numerous options available for the surgical treatment of benign prostate hyperplasia, and single-port robotic-assisted simple prostatectomy (SP-RASP) has emerged as a novel method in this field. In this study, we aim to define the trifecta of same-day discharge (SDD) and identify the factors associated with the trifecta of SDD following SP-RASP. <b><i>Materials and Methods:</i></b> Data from 95 patients who underwent SP-RASP between February 2020 and July 2024 at a single center by a single surgeon were evaluated. The trifecta of SDD was defined as a patient being discharged on the same day without experiencing any 90-day postoperative complications and no readmissions. The factors associated with predicting the trifecta of SDD were investigated. <b><i>Results:</i></b> A total of 95 SP-RASP cases were successfully performed without the need for conversion to alternative approaches, and 54 patients (56.8%) were included in the trifecta of the SDD-achieved group. The reasons for failure included 23 patients (24.2%) requiring postoperative hospitalization from the recovery area, 24 patients (25.3%) experiencing postoperative complications, and 2 patients (2.1%) needing readmission within 90 days after discharge. There was a 0% incidence of major postoperative complications (≥Clavien-Dindo grade 3). When comparing the groups, trifecta-achieved patients showed lower estimated blood loss, smaller specimen weight, lower percentage of adenoma removed, and a reduced rate of opioid prescriptions at discharge (<i>p</i> = 0.005, 0.033, 0.025, and 0.026, respectively). In the multivariate logistic regression analysis, specimen weight was the only factor significantly associated with trifecta following SP-RASP (<i>p</i> = 0.018). <b><i>Conclusion:</i></b> In our cohort, 56% of patients were classified within the trifecta group, with no major postoperative complications observed following SP-RASP. Specimen weight was the only independent predictor of trifecta achievement in these patients.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of endourology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/end.2024.0930","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: There are numerous options available for the surgical treatment of benign prostate hyperplasia, and single-port robotic-assisted simple prostatectomy (SP-RASP) has emerged as a novel method in this field. In this study, we aim to define the trifecta of same-day discharge (SDD) and identify the factors associated with the trifecta of SDD following SP-RASP. Materials and Methods: Data from 95 patients who underwent SP-RASP between February 2020 and July 2024 at a single center by a single surgeon were evaluated. The trifecta of SDD was defined as a patient being discharged on the same day without experiencing any 90-day postoperative complications and no readmissions. The factors associated with predicting the trifecta of SDD were investigated. Results: A total of 95 SP-RASP cases were successfully performed without the need for conversion to alternative approaches, and 54 patients (56.8%) were included in the trifecta of the SDD-achieved group. The reasons for failure included 23 patients (24.2%) requiring postoperative hospitalization from the recovery area, 24 patients (25.3%) experiencing postoperative complications, and 2 patients (2.1%) needing readmission within 90 days after discharge. There was a 0% incidence of major postoperative complications (≥Clavien-Dindo grade 3). When comparing the groups, trifecta-achieved patients showed lower estimated blood loss, smaller specimen weight, lower percentage of adenoma removed, and a reduced rate of opioid prescriptions at discharge (p = 0.005, 0.033, 0.025, and 0.026, respectively). In the multivariate logistic regression analysis, specimen weight was the only factor significantly associated with trifecta following SP-RASP (p = 0.018). Conclusion: In our cohort, 56% of patients were classified within the trifecta group, with no major postoperative complications observed following SP-RASP. Specimen weight was the only independent predictor of trifecta achievement in these patients.
期刊介绍:
Journal of Endourology, JE Case Reports, and Videourology are the leading peer-reviewed journal, case reports publication, and innovative videojournal companion covering all aspects of minimally invasive urology research, applications, and clinical outcomes.
The leading journal of minimally invasive urology for over 30 years, Journal of Endourology is the essential publication for practicing surgeons who want to keep up with the latest surgical technologies in endoscopic, laparoscopic, robotic, and image-guided procedures as they apply to benign and malignant diseases of the genitourinary tract. This flagship journal includes the companion videojournal Videourology™ with every subscription. While Journal of Endourology remains focused on publishing rigorously peer reviewed articles, Videourology accepts original videos containing material that has not been reported elsewhere, except in the form of an abstract or a conference presentation.
Journal of Endourology coverage includes:
The latest laparoscopic, robotic, endoscopic, and image-guided techniques for treating both benign and malignant conditions
Pioneering research articles
Controversial cases in endourology
Techniques in endourology with accompanying videos
Reviews and epochs in endourology
Endourology survey section of endourology relevant manuscripts published in other journals.