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当日出院机器人辅助根治性前列腺切除术:全国年度分析

Same-day-discharge Robot-assisted Radical Prostatectomy: An Annual Countrywide Analysis.

作者信息

Ploussard Guillaume, Grabia Annabelle, Barret Eric, Beauval Jean-Baptiste, Brureau Laurent, Créhange Gilles, Dariane Charles, Fiard Gaëlle, Fromont Gaëlle, Gauthé Mathieu, Mathieu Romain, Renard-Penna Raphaële, Roubaud Guilhem, Ruffion Alain, Sargos Paul, Rouprêt Morgan, Lequeu Charles-Edouard

机构信息

Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France.

Department of Public Health, PMSI, Ramsay Santé, Paris, France.

出版信息

Eur Urol Open Sci. 2021 Dec 23;36:23-25. doi: 10.1016/j.euros.2021.12.002. eCollection 2022 Feb.

Abstract

UNLABELLED

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 ( < 0.001). No difference in readmission rate (7.9% vs 5.1%; = 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.

PATIENT SUMMARY

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.

摘要

未标注

目前尚无关于机器人辅助根治性前列腺切除术(RARP)当日出院(SDD)手术使用情况的全国性数据。我们旨在评估法国每年进行的SDD RARP手术数量,并比较SDD中心与非SDD中心的术后结果。从国家医疗系统的中央数据库中提取了2020年在法国接受RARP手术的所有9651例患者的数据。观察指标包括住院时间、患者年龄、中心手术量、淋巴结清扫情况以及医院再入院率。总体而言,在14.2%的RARP中心报告了184例SDD病例(1.9%)。在SDD中心,每年的RARP和SDD RARP手术量分别为41至485例和1至47例。SDD与手术量较大的中心显著相关(<0.001)。SDD中心与非SDD中心的再入院率无差异(7.9%对5.1%;P = 0.141)。SDD中心的直接住院费用估计为1457欧元,而非SDD中心为2021欧元。主要局限性在于缺乏详细的患者特征和再入院原因。这项年度全国性分析表明,尽管SDD RARP与RARP术后具有可比的短期结果以及潜在的成本效益,但在法国的常规实践中仍很少使用。

患者总结

我们评估了法国对前列腺癌男性患者进行机器人辅助前列腺切除术(RARP)并当日出院的情况。2020年,在9651例RARP手术中,只有1.9%涉及当日出院,尽管数据显示这种方法成本更低且安全性相当。

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