Preliminary results of the implementation of robotic radical prostatectomy in a major ambulatory surgery regimen.

OBJECTIVE: To report our initial experience with robotic radical prostatectomy as an outpatient procedure. MATERIAL AND METHODS: Retrospective analysis of patients who underwent RRP as MAS (Major Ambulatory Surgery) at our center between March 2021 and May 2022. We collected baseline patient characteristics, intraoperative outcomes and postoperative data (need for unplanned medical care and complications at one month after surgery). Oncologic characteristics at disease diagnosis (PSA, staging, ISUP, MRI) and postoperative pathologic outcomes were collected. RESULTS: We identified a total of 35 patients with an average age of 60,8 ± 6,88 years and a BMI of 27 ± 2,9 Kg/m2. All patients had a low anesthetic risk and 25.71% had undergone previous abdominal surgery. The surgical time was 151,66 ± 42,15 min and the average blood loss was 301,2 ± 184,38 mL. Two patients (5.7%) were admitted for one night and 7 patients (20%) consulted the emergency department in the following month, of which 3 (8.57%) were readmitted. We recorded one intraoperative complication, seven mild postoperative complications (Clavien I-II) and one severe complication (Clavien IIIb). The severe complication occurred on the eighth postoperative day and was not related to the procedure being ambulatory. CONCLUSION: The absence of serious complications in the immediate postoperative period supports RRP in MAS as a safe technique for selected patients.

Resultados preliminares de la implementación de la prostatectomía radical robótica en régimen de cirugía mayor ambulatoria / Preliminary results of the implementation of robotic radical prostatectomy in a major ambulatory surgery regimen

Objetivo Reportar nuestra experiencia inicial de prostatectomía radical robótica (PRR) en régimen ambulatorio. Material y métodos Análisis retrospectivo de los pacientes intervenidos de PRR en cirugía mayor ambulatoria (CMA) en nuestro centro entre marzo de 2021 y mayo de 2022. Recopilamos las características basales de los pacientes, los resultados intraoperatorios y los datos del postoperatorio (necesidad de asistencia médica no planificada y complicaciones al mes de la cirugía). Se recogieron las características oncológicas al diagnóstico de la enfermedad (PSA, estadificación, ISUP, RMN) y el resultado anatomopatológico tras la intervención. Resultados Identificamos un total de 35 pacientes, con una edad promedio de 60,8 ±6,88 años y un IMC de 27 ±2,9kg/m2. Todos presentaban un riesgo anestésico bajo y un 25,71% tenían alguna cirugía abdominal previa. El tiempo quirúrgico fue de 151,66 ±42,15 minutos y el sangrado promedio fue de 301,2 ±184,38mililitros. Dos pacientes (5,7%) ingresaron la primera noche de la cirugía y 7 pacientes (20%) consultaron en urgencias en el mes siguiente, de los cuales 3 (8,57%) reingresaron. Registramos una complicación intraoperatoria, 7 complicaciones postoperatorias leves (ClavienI-II) y una complicación grave (ClavienIIIb). La complicación grave transcurrió al octavo día postoperatorio y no tuvo relación con la ambulatorización del procedimiento. Conclusión La ausencia de complicaciones graves en el postoperatorio inmediato avala la PRR en régimen de CMA como una técnica segura dirigida a pacientes seleccionados (AU)

Objective To report our initial experience with robotic radical prostatectomy (RRP) as an outpatient procedure. Material and methods Retrospective analysis of patients who underwent RRP as major ambulatory surgery (MAS) at our center between March 2021 and May 2022. We collected baseline patient characteristics, intraoperative outcomes and postoperative data (need for unplanned medical care and complications at one month after surgery). Oncologic characteristics at disease diagnosis (PSA, staging, ISUP, MRI) and postoperative pathologic outcomes were collected. Results We identified a total of 35 patients with an average age of 60,8 ±6,88years and a BMI of 27 ±2,9kg/m2. All patients had a low anesthetic risk and 25.71% had undergone previous abdominal surgery. The surgical time was 151,66 ±42,15minutes and the average blood loss was 301,2 ±184,38milliliters. Two patients (5.7%) were admitted for one night and 7 patients (20%) consulted the emergency department in the following month, of which 3 (8.57%) were readmitted. We recorded one intraoperative complication, 7 mild postoperative complications (ClavienI-II) and one severe complication (ClavienIIIb). The severe complication occurred on the eighth postoperative day and was not related to the procedure being ambulatory. Conclusion The absence of serious complications in the immediate postoperative period supports RRP in MAS as a safe technique for selected patients (AU)