Bernhard Jean-Christophe, Payan Anne, Bensadoun Henri, Cornelis François, Pierquet Grégory, Pasticier Gilles, Robert Grégoire, Capon Grégoire, Ravaud Alain, Ferriere Jean-Marie
Department of Urology and Kidney Transplant, CHU Bordeaux, University of Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France.
French Research Network on Kidney Cancer UroCCR, Bordeaux, France.
World J Urol. 2016 Jun;34(6):883-7. doi: 10.1007/s00345-015-1746-6. Epub 2015 Dec 16.
Fast-track and day-case surgeries are gaining more and more importance. Their development was eased by the diffusion of minimal invasive surgical strategies and the consequential morbidity reduction. In the field of kidney cancer, seven cases of ambulatory radical nephrectomy were previously reported in the international literature. Regarding robotic partial nephrectomy (PN), short postoperative pathways resulting in patients' discharge on postoperative day 1 were shown to be safe and feasible. We report our initial experience of robot-assisted PN discharged on postoperative day zero and discuss the criteria for adequate patient selection. Indeed, outpatient PN will obviously not be suitable for all patients, and careful selection will be mandatory. Both specific baseline patient's factors and postoperative events will have to be recognized for the first ones and prevented for the second ones. Safety, patient satisfaction, cost efficiency, and reproducibility will be the key factors to assess and promote day-case PN.
快速通道手术和日间手术正变得越来越重要。微创外科手术策略的普及以及随之而来的发病率降低推动了它们的发展。在肾癌领域,国际文献中先前报道了7例门诊根治性肾切除术。关于机器人辅助部分肾切除术(PN),术后短期恢复路径使患者在术后第1天出院已被证明是安全可行的。我们报告了我们在术后第0天出院的机器人辅助PN的初步经验,并讨论了合适的患者选择标准。事实上,门诊PN显然并不适用于所有患者,必须进行仔细筛选。对于前者必须识别患者特定的基线因素,对于后者必须预防术后事件。安全性、患者满意度、成本效益和可重复性将是评估和推广日间PN的关键因素。