There are no countrywide data regarding the utilization of same-day-discharge (SDD) surgery for robot-assisted radical prostatectomy (RARP). We aimed to evaluate the annual number of SDD RARP procedures in France and to compare postoperative outcomes in SDD versus non-SDD centers. Data for all 9651 patients undergoing RARP in France in 2020 were extracted from the central database of the national healthcare system. Endpoints were length of hospital stay, patient age, center volume, lymph node dissection, and the hospital readmission rate. Overall, 184 SDD cases (1.9%) were reported in 14.2% of RARP centers. The annual RARP and SDD RARP caseload ranged from 41 to 485, and from one to 47, respectively, in SDD centers. SDD was significantly associated with higher-volume centers (p < 0.001). No difference in readmission rate (7.9% vs 5.1%; p = 0.141) was observed for SDD versus non-SDD centers. Direct stay costs were estimated at €1457 in SDD centers compared to €2021 in non-SDD centers. The main limitation is the lack of detailed patient characteristics and readmission causes. This annual nationwide analysis suggests that SDD RARP remains infrequently used in routine practice in France despite being associated with comparable short-term outcomes after RARP and potential cost benefits.
We evaluated the use of robot-assisted removal of the prostate (RARP) with same-day hospital discharge in France for men with prostate cancer. In 2020, only 1.9% of the 9651 RARP procedures involved same-day discharge, even though the data show that this approach has lower costs and comparable safety.
European urology open science. 2021 Dec 23*** epublish ***
Guillaume Ploussard, Annabelle Grabia, Eric Barret, Jean-Baptiste Beauval, Laurent Brureau, Gilles Créhange, Charles Dariane, Gaëlle Fiard, Gaëlle Fromont, Mathieu Gauthé, Romain Mathieu, Raphaële Renard-Penna, Guilhem Roubaud, Alain Ruffion, Paul Sargos, Morgan Rouprêt, Charles-Edouard Lequeu, Cancerology Committee of Association Française d'Urologie
Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France., Department of Public Health, PMSI, Ramsay Santé, Paris, France., Department of Urology, Institut Mutualiste Montsouris, Paris, France., Department of Urology, CHU de Pointe-à-Pitre, Pointe-à-Pitre, France., Department of Radiotherapy, Institut Curie, Paris, France., Department of Urology, Hôpital Européen Georges-Pompidou, APHP, Paris University, Paris, France., Department of Urology, Grenoble Alpes University Hospital, Université Grenoble Alpes, Grenoble, France., Department of Pathology, CHRU Tours, France., INSERM UMR 1153, Unité de Recherche Clinique en Économie de la Santé, Paris, France., Department of Urology, CHU Rennes, Rennes, France., Department of Radiology, Pitie-Salpetriere Hospital, APHP, Sorbonne University, Paris, France., Department of Medical Oncology, Institut Bergonié, Bordeaux, France., Service d'Urologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France., Department of Radiotherapy, Institut Bergonié, Bordeaux, France., GRC 5 Predictive Onco-Uro, Department of Urology, Pitie-Salpetriere Hospital, APHP, Sorbonne University, Paris, France.