PURPOSE - To test the feasibility and safety of performing laparoscopic nephrectomy (LN) on renal cancer patients as outpatient surgery.
MATERIALS AND METHODS - A prospective, multicenter, descriptive study was conducted between April 2014 and February 2015, with postoperative follow-up at thirty days.
In total, 140 patients were diagnosed with renal cancer during this period. 50 patients met the inclusion criteria and agreed to participate. Reasons for exclusion included planned partial nephrectomy (n=35), lived alone without adequate home support (n=17), advanced age or significant co-morbid conditions (n=33) and declined to participate (n=5).
OUTCOME MEASURES AND STATISTICAL ANALYSIS - Pain, nausea, fatigue, operations time, bleeding, time to stay in the postoperative care unit and hospital stay were assessed. Continuous variables were compared using a paired t-test, and categorical variables were compared using Fisher's exact test.
RESULTS - The mean age of the patients undergoing planned outpatient surgery was 59. 8 years [35 (70%) males; 15 (30%) females]. Forty-six patients (92%) were discharged within the first 6 hours after surgery. Four patients (8%) could not be discharged, 2 patients because of wrong medication, one patient due to fatigue and another one due to intestinal injury. None of the 46 early-discharge patients were readmitted to the hospital, 2 patients had haft wound infection with a good results of oral antibiotic treatment without re-admission.
CONCLUSIONS - LN may be performed as outpatient surgery in carefully selected patients meeting inclusion criteria (>40% of candidates for LN). Our study demonstrates that outpatient nephrectomy may be done safely and does not require readmission.
The Journal of urology. 2016 Jan 06 [Epub ahead of print]
Nessn H Azawi, Tom Christensen, Claus Dahl, Lars Lund
Department of Urology, Roskilde Hospital, Roskilde, Denmark; Institute of Clinical Research, University of Southern Denmark. Department of Urology, Roskilde Hospital, Roskilde, Denmark. , Department of Urology, Roskilde Hospital, Roskilde, Denmark. , Department of Urology, Odense University Hospital, Odense, Denmark; Institute of Clinical Research, University of Southern Denmark.