Touzani Alae, Vuong Nam-Son, Uleri Alessandro, Fallara Giuseppe, Martini Alberto, Miaadi Naoufel, Deffar Nordine, Ouzzane Adil, Pradère Benjamin, Rouffilange Jean, Baboudjian Michaël, Beauval Jean-Baptiste, Malavaud Bernard, Ploussard Guillaume
Urology Department, La Croix du Sud Hospital, Ramsay Santé Group, Quint Fonsegrives, France.
Urology Department, Casablanca International Oncology Center, Casablanca, Morocco.
Transl Androl Urol. 2025 May 30;14(5):1348-1354. doi: 10.21037/tau-2025-74. Epub 2025 May 27.
Robotic surgery has demonstrated its ability to improve perioperative outcomes thanks to a minimally invasive approach. In addition, the implementation of a perioperative optimized pathway, including eHealth programs, may provide a synergistic effect and help facilitate recovery and reduce complications. The purpose of this study is to evaluate the impact of the BETTY COACHING program on the 90-day complication rate following robot-assisted oncologic urologic surgery.
We conducted a study to evaluate the impact of the BETTY COACHING program, an app-based, multi-level perioperative digital pathway, on the 90-day complication rate following robot-assisted onco-urologic surgery. Patients were divided into two groups: one benefiting from our coaching program and the other receiving standard care without digital support. Data were analyzed from a prospectively maintained, multicenter registry. Secondary endpoints included hospital stay, readmission, number of days out of hospital, prolonged care at discharge, unplanned visits, and patient satisfaction.
A total of 196 consecutive patients undergoing radical prostatectomy, partial nephrectomy, or radical cystectomy were included in the analysis, with 98 patients in each group. Patients who followed our coaching program experienced significantly fewer post-operative complications [26.5% 9.2%; odds ratios (OR) 0.28; P=0.002] compared to those in the standard care group. The digital program was also associated with a significant reduction in unplanned visits (OR 0.08; P=0.003), readmission rates (OR 0.23; P=0.02), and prolonged care after discharge (OR 0.21; P=0.004). Additionally, patients in the coaching program group had a higher number of days out of the hospital within 90 days post-surgery (89.1 87.5 days; P=0.002) and reported greater satisfaction (9.1 7.7/10; P=0.02).
The addition of a digital optimized perioperative program improves 90-day outcomes after robot-assisted onco-urologic surgical procedures in terms of complications, readmission, prolonged care, and patient experience.
机器人手术已通过微创方法证明其能够改善围手术期结局。此外，实施包括电子健康计划在内的围手术期优化路径可能会产生协同效应，并有助于促进康复和减少并发症。本研究的目的是评估BETTY指导计划对机器人辅助肿瘤泌尿外科手术后90天并发症发生率的影响。
我们进行了一项研究，以评估BETTY指导计划（一种基于应用程序的多层次围手术期数字路径）对机器人辅助肿瘤泌尿外科手术后90天并发症发生率的影响。患者分为两组：一组受益于我们的指导计划，另一组接受无数字支持的标准护理。数据来自前瞻性维护的多中心登记处。次要终点包括住院时间、再入院率、出院后出院天数、出院时延长护理、非计划就诊次数和患者满意度。
共有196例连续接受根治性前列腺切除术、部分肾切除术或根治性膀胱切除术的患者纳入分析，每组98例。与标准护理组相比，遵循我们指导计划的患者术后并发症明显更少[26.5%对9.2%；优势比（OR）0.28；P=0.002]。数字计划还与非计划就诊次数显著减少（OR 0.08；P=0.003）、再入院率（OR 0.23；P=0.02）和出院后延长护理显著减少（OR 0.21；P=0.004）相关。此外，指导计划组的患者在手术后90天内出院天数更多（89.1对87.5天；P=0.002），且报告的满意度更高（9.1对7.7/10；P=0.02）。
在机器人辅助肿瘤泌尿外科手术中增加数字优化围手术期计划可在并发症、再入院、延长护理和患者体验方面改善90天结局。
