Predictors of Same-day Discharge After Single-Port Transvesical Enucleation of the Prostate.

Autor: Ramos-Carpinteyro R; Cleveland Clinic, Cleveland, OH., Soputro N; Cleveland Clinic, Cleveland, OH., Pedraza AM; Cleveland Clinic, Cleveland, OH., Mikesell C; Cleveland Clinic, Cleveland, OH., Chavali JS; Cleveland Clinic, Cleveland, OH., Beksac AT; Cleveland Clinic, Cleveland, OH., Eltemamy M; Cleveland Clinic, Cleveland, OH., Schwen ZR; Cleveland Clinic, Cleveland, OH., Kaouk J; Cleveland Clinic, Cleveland, OH. Electronic address: kaoukj@ccf.org.
Jazyk: angličtina
Zdroj: Urology [Urology] 2024 May 16. Date of Electronic Publication: 2024 May 16.
DOI: 10.1016/j.urology.2024.05.005
Abstrakt: Objective: To determine the rate of outpatient cases and identify predictors for same-day discharge (SDD) after single-port transvesical enucleation of the prostate (STEP).
Methods: Retrospective analysis of all consecutive STEP cases performed at a single center by 3 surgeons from February 2019 to October 2023. The cohort was categorized into SDD cases (<8 hours until discharge) and inpatient cases. Group comparisons were made and logistic regression was used to identify predictors of SDD.
Results: A total of 152 STEP cases were performed successfully without additional ports or conversions. Fifty-two patients were pre-planned admissions, leaving 100 planned outpatient cases, of which 86% were discharged on the same day (median length of stay of 4.7 hours). Comparing the groups, inpatient cases were older, had higher Charlson Comorbidity Index (CCI) scores, higher estimated blood loss (EBL) during surgery, and more intraoperative complications than SDD patients. Univariate logistic regression identified age and CCI as the predictors associated with SDD after STEP. Notably, there were no major postoperative complications or readmissions in either group.
Conclusion: In our 4-year experience with STEP, lower age and CCI score were significant predictors of SDD. The comprehensive evaluation criteria for discharge foster a safe recovery at home, coupled with a 0% rate of major postoperative complications and readmissions. These findings underscore the safety and efficacy of STEP, guiding patient counseling and surgeon expectations.
Competing Interests: Declaration of Competing Interest Jihad Kaouk is a consultant for Intuitive, VTI, and Endoquest Robotics. The remaining authors declare that they have no conflict of interest.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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